The Cigna Group
The Cigna Group
The Cigna Group एक वैश्विक स्वास्थ्य सेवा और बीमा कंपनी है, जो व्यक्तियों, परिवारों, नियोक्ताओं, दलालों, स्वास्थ्य सेवा प्रदाताओं और मेडिकेयर लाभार्थियों को सेवाएँ प्रदान करती है। इसके प्रस्तावों में चिकित्सा, दंत चिकित्सा, फार्मेसी, व्यवहारिक स्वास्थ्य, पूरक कवरेज, नियोक्ता-प्रायोजित योजनाएँ, व्यक्तिगत और पारिवारिक बीमा, मेडिकेयर तथा 200 से अधिक देशों में अंतरराष्ट्रीय स्वास्थ्य बीमा शामिल हैं। कंपनी myCigna के माध्यम से टेलीहेल्थ और दावों के प्रबंधन जैसी डिजिटल सदस्य सेवाएँ भी प्रदान करती है। इसके उत्पाद परिचालन सहायक कंपनियों और क्षेत्रीय सहयोगी संस्थाओं के माध्यम से उपलब्ध कराए जाते हैं।

Senior Enrollment and Billing Representative, Home Infusion (Remote - Pennsylvania)

Senior representative responsible for pharmacy claims, collections, appeals, and reimbursement follow-up across Evernorth’s specialty pharmacy and home infusion services. The role manages accounts receivable and payer activity to support accurate payment resolution.

विवरण

  • Manage pharmacy claim billing, collections, and follow-up to support timely and accurate reimbursement
  • Investigate denied, rejected, and underpaid claims and apply appropriate corrective action
  • Review explanations of benefits (EOBs) to confirm reimbursement accuracy and determine required next steps
  • Track accounts receivable and address outstanding balances through payer and patient outreach
  • Prepare, submit, and monitor payer appeals within established deadlines
  • Assess payer requirements and reimbursement policies to decide whether claims require correction, refiling, or appeal
  • Find and correct billing and submission errors that affect reimbursement
  • Record collection activity in patient notes and designated reporting systems
  • Work with colleagues and leaders to improve workflows, efficiency, compliance, and financial results
  • Provide support for CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization

आवश्यकताएँ

  • High school diploma or GED
  • At least two years of experience in collections, accounts receivable, medical billing, healthcare claims, pharmacy billing, or insurance collections
  • Working knowledge of reimbursement processes for commercial, Medicare, Medicaid, self-pay, and third-party plans
  • Ability to interpret explanations of benefits (EOBs) and billing correspondence
  • Strong communication, organizational, and problem-solving abilities with a customer-focused approach
  • Proficiency with Microsoft 365 and electronic health record or billing systems
  • Preferred: Two or more years of experience in revenue cycle operations, pharmacy billing, or collections
  • Preferred: Experience with ICD-10, CPT, HCPCS, and Medicare billing guidelines
  • Preferred: Knowledge of pharmacy Part D claims, CE2000, home infusion billing, and third-party payer requirements
  • Preferred: Experience with HCN360, CPR+, or comparable billing platforms

लाभ

  • Eligibility for an annual bonus plan
  • Medical, vision, and dental coverage beginning on the first day
  • Well-being and behavioral health programs
  • 401(k) plan
  • Company-paid life insurance
  • Tuition reimbursement
  • At least 18 days of paid time off each year
  • Paid holidays
  • Leaves of absence
  • Tobacco-free policy
  • Home internet requirement and support for occasional or permanent work from home

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