The Cigna Group
The Cigna Group
The Cigna Group एक वैश्विक स्वास्थ्य सेवा कंपनी है, जो Cigna Healthcare और Evernorth Health Services के माध्यम से कार्य करती है। इसका काम स्वास्थ्य सेवाओं, स्वास्थ्य बीमा और फार्मेसी लाभ प्रबंधन को एकीकृत करके ग्राहकों, क्लाइंट्स और रोगियों के स्वास्थ्य एवं कल्याण में सहायता करना है। कंपनी नैतिक स्वास्थ्य सेवा और कृत्रिम बुद्धिमत्ता से जुड़ी प्रथाओं, स्वास्थ्य समानता, जिम्मेदार पर्यावरणीय और सामाजिक शासन तथा स्वास्थ्य सेवाएं प्रदान करने के तरीकों में नवाचार पर भी ध्यान केंद्रित करती है।

Senior Home Infusion Enrollment and Billing Representative

Manage pharmacy billing, collections, appeals, and reimbursement issues for home infusion services. Support specialty pharmacy operations while helping improve patients’ financial experience.

विवरण

  • Manage pharmacy claim billing, collections, and follow-up activities
  • Investigate denied, rejected, and underpaid claims, then apply appropriate corrective actions
  • Review explanations of benefits (EOBs) to confirm reimbursement accuracy and determine next steps
  • Monitor accounts receivable and pursue outstanding balances through payer and patient outreach
  • Prepare, submit, and track payer appeals within required deadlines
  • Assess payer rules and reimbursement guidelines to determine whether claims require correction, refiling, or appeal
  • Correct billing and claim-submission errors that affect reimbursement
  • Document collection activity promptly in patient records and reporting systems
  • Collaborate with colleagues and leaders to improve workflows, efficiency, compliance, and financial results
  • Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization in providing specialty pharmacy and infusion services

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 or billing systems
  • Experience in revenue cycle operations, pharmacy billing, or collections is preferred
  • Familiarity with ICD-10, CPT, HCPCS, and Medicare billing guidelines is preferred
  • Knowledge of pharmacy Part D claims, CE2000, home infusion billing, and third-party payer requirements is preferred
  • Experience with HCN360, CPR+, or comparable billing platforms is preferred
  • Home-based work requires cable broadband or fiber-optic internet with at least 10 Mbps download and 5 Mbps upload speeds

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 annually
  • Paid holidays
  • Leaves of absence
  • Remote work arrangement
  • Cable broadband or fiber-optic internet required for working from home

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