Medical Collections Specialist, Home Infusion

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🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟢 Junior

📞 Collections

🚫👨‍🎓 No degree required

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• Support strong reimbursement outcomes by collecting on insurance claims and moving unpaid accounts toward timely resolution. • Research denials, rejections, and payment issues to find root causes and recommend steps that help prevent repeat problems. • Submit payer appeals within required time frames and use clear documentation to support accurate claim review. • Review patient account details, claim status, and explanations of benefits to decide the best next action, such as correction, refiling, adjustment, or appeal. • Investigate claims and payer contracts to confirm payment accuracy and identify reimbursement gaps, with attention to home infusion billing requirements when applicable. • Communicate with patients, payers, outside agencies, and internal partners in a professional, helpful, and timely manner. • Document collection activity, account actions, and outcomes in patient notes, AR Aging Reports, and Over/Under Reports. • Track account trends and share insights that support process improvements, stronger collections, and better revenue cycle results. • Meet quality, productivity, and service standards while working independently and as part of a collaborative team.

🎯 Requirements

• High school diploma or GED. • 1+ year of experience in medical collections, medical billing, revenue cycle, healthcare administration, or a related role. • Experience working with insurance claims, denials, appeals, payer follow-up, or account resolution. • Ability to read and interpret an explanation of benefits (EOB) and understand claim payment or denial activity. • Knowledge of insurance policies, third-party payer guidelines, and reimbursement practices. • Strong customer service, communication, organization, and problem-solving skills. • Ability to communicate clearly by phone, email, and written correspondence with patients, payers, and internal partners. • Strong attention to detail and ability to manage multiple priorities in a fast-paced environment. • Ability to handle sensitive information with care, discretion, and confidentiality. • Ability to perform basic math calculations and review account data accurately. • Strongly preferred: 1+ year of experience in home infusion billing, home infusion collections, specialty pharmacy, or a closely related healthcare setting. • 2+ years of experience in medical collections, medical billing, revenue cycle, or healthcare financial operations. • Working knowledge of ICD-10, CPT, HCPCS, and medical terminology. • Familiarity with Medicare billing requirements, including DMEMAC guidelines. • Experience with HCN360, CPR+, or similar healthcare billing systems. • Associate or bachelor's degree in healthcare administration, business, finance, or a related field.

🏖️ Benefits

• Health insurance • Flexible work arrangements • Professional development opportunities