The Cigna Group
The Cigna Group
The Cigna Group — жеке тұлғаларға, отбасыларға, жұмыс берушілерге, брокерлерге, медициналық қызмет көрсетушілерге және Medicare бағдарламасының бенефициарларына қызмет көрсететін жаһандық денсаулық сақтау және сақтандыру компаниясы. Оның ұсыныстарына медициналық, стоматологиялық, фармацевтикалық және мінез-құлықтық денсаулық сақтау қызметтері, қосымша сақтандыру, жұмыс беруші қаржыландыратын жоспарлар, жеке тұлғалар мен отбасыларға арналған сақтандыру, Medicare және 200-ден астам елдегі халықаралық медициналық сақтандыру кіреді. Компания сондай-ақ myCigna арқылы телемедицина мен талаптарды басқаруды қоса алғанда, цифрлық мүшелік қызметтерді ұсынады; өнімдер операциялық еншілес компаниялар мен өңірлік аффилиирленген ұйымдар арқылы жеткізіледі.

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.

Сипаттама

  • 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

Талаптар

  • 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

Артықшылықтар

  • 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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