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The Cigna Group
The Cigna Group
AsigurăriAsistență medicală
The Cigna Group este o companie globală de servicii medicale și asigurări, care deservește persoane fizice, familii, angajatori, brokeri, furnizori de servicii medicale și beneficiari Medicare. Oferta sa include servicii medicale și stomatologice, produse farmaceutice, servicii de sănătate comportamentală, acoperiri suplimentare, planuri sponsorizate de angajatori, asigurări pentru persoane fizice și familii, Medicare și asigurări internaționale de sănătate în peste 200 de țări. Compania oferă, de asemenea, servicii digitale pentru membri prin myCigna, inclusiv servicii medicale la distanță și gestionarea solicitărilor de despăgubire, prin produse furnizate de subsidiare operaționale și afiliați regionali.
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Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiPAPennsylvania
20 $ – 30 $ / oră
RemoteNormă întreagăSeniorLimbă Obligatorie: englezăSpecialist în facturare

Descriere

  • 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

Cerințe

  • 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

Beneficii

  • 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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