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The Cigna Group
The Cigna Group
Asigurare de sănătateAsistență medicalăProduse farmaceutice
The Cigna Group este o companie globală din domeniul sănătății, care își desfășoară activitatea prin Cigna Healthcare și Evernorth Health Services. Activitatea sa combină serviciile de sănătate, asigurările de sănătate și gestionarea beneficiilor farmaceutice pentru a sprijini sănătatea și bunăstarea clienților, beneficiarilor și pacienților. Compania se concentrează, de asemenea, pe practici etice în domeniul sănătății și al inteligenței artificiale, pe echitatea în sănătate, pe guvernanța de mediu și socială responsabilă și pe inovarea modului în care sunt furnizate îngrijirile.
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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.

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

Descriere

  • 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

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 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

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

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