The Cigna Group
The Cigna Group
„The Cigna Group“ yra pasaulinė sveikatos priežiūros bendrovė, veikianti per „Cigna Healthcare“ ir „Evernorth Health Services“. Jos veikla apima sveikatos priežiūros paslaugas, sveikatos draudimą ir vaistinių išmokų administravimą, siekiant prisidėti prie klientų, verslo klientų ir pacientų sveikatos bei gerovės. Bendrovė taip pat daug dėmesio skiria etiškai sveikatos priežiūros ir dirbtinio intelekto taikymo praktikai, sveikatos lygybei, atsakingam aplinkosaugos ir socialiniam valdymui bei naujovėms teikiant priežiūrą.

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.

Aprašymas

  • 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

Reikalavimai

  • 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

Privalumai

  • 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

Susiję darbai

Red Hat

Consulting Cloud Architect, OpenShift

Red Hat

Design and deliver Red Hat OpenShift, Kubernetes, and hybrid cloud solutions for enterprise customers. Lead customer engagements focused on infrastructure, automation, and application delivery.

Atidaryti
Kreato Global | BPO and Language Solutions

Remote English-Spanish OPI/VRI Interpreter

Kreato Global | BPO and Language Solutions

Interpret remotely between English- and Spanish-speaking people in medical, financial, social service, and customer care settings. Provide language support for Kreato Global across Latin America.

Atidaryti
RecruitGo

Remote Executive Assistant, Outreach and Marketing — Philippines

RecruitGo
51 – 200 Darbuotojai
KonsultavimasLogistikaRinkodara

Handle administrative support, CRM, outreach, and marketing for RecruitGo, an Employer of Record serving global clients with talent from emerging markets. Support two UK-facing clients with day-to-day administration and creative campaigns.

Atidaryti