The Cigna Group
The Cigna Group
The Cigna Group jismoniy shaxslar, oilalar, ish beruvchilar, brokerlar, tibbiy xizmat ko‘rsatuvchilar va Medicare benefitsiarlariga xizmat ko‘rsatuvchi global sog‘liqni saqlash va sug‘urta kompaniyasidir. Kompaniya takliflari tibbiy, stomatologik, farmatsevtik va xulq-atvor salomatligi xizmatlari, qo‘shimcha sug‘urta, ish beruvchi homiyligidagi rejalar, jismoniy shaxslar va oilalar uchun sug‘urta, Medicare hamda 200 dan ortiq mamlakatdagi xalqaro tibbiy sug‘urtani qamrab oladi. Shuningdek, kompaniya myCigna orqali telemeditsina va da’volarni boshqarishni o‘z ichiga olgan raqamli a’zo xizmatlarini taqdim etadi; mahsulotlar operatsion sho‘ba korxonalar va mintaqaviy hamkor tashkilotlar orqali yetkazib beriladi.

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.

Tavsif

  • 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

Talablar

  • 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

Imtiyozlar

  • 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

O‘xshash ish o‘rinlari

Johnson & Johnson

Director, Patient and Customer Experience – Johnson & Johnson, Singapore

Johnson & Johnson

Lead Johnson & Johnson’s APAC patient experience, patient support and commercial AI strategy from Singapore. Drive regional customer experience adoption, market execution and cross-functional healthcare innovation.

Ochish