Senior Enrollment/Billing Representative, Home Infusion

🔥 38 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $20 - $30 / hour

⏰ Full Time

🟠 Senior

📊 Billing Specialist

👻 Ghost score 0%

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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

• Drive timely and accurate reimbursement by managing pharmacy claim billing, collections, and follow-up activities • Resolve denied, rejected, or underpaid claims by identifying root causes and applying corrective strategies • Interpret explanations of benefits (EOBs) to validate reimbursement accuracy and determine next steps • Monitor accounts receivable and manage outstanding balances through payer or patient outreach • Prepare, submit, and track payer appeals within required timeframes • Evaluate payer rules and reimbursement guidelines to determine whether claims should be corrected, refiled, or appealed • Identify and correct billing or submission errors impacting reimbursement • Maintain documentation of collection activity in patient notes and reporting tools • Partner with teammates and leaders to identify workflow improvements that strengthen efficiency, compliance, and financial performance • Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization

🎯 Requirements

• High school diploma or GED • Minimum of 2 years of experience in collections, A/R, medical billing, healthcare claims, pharmacy billing, or insurance-related collections • Working knowledge of payer reimbursement processes including commercial, Medicare, Medicaid, self-pay, and third-party plans • Ability to read and interpret explanations of benefits (EOBs) and billing correspondence • Strong communication, organization, and problem-solving skills with a customer-focused mindset • Proficiency in Microsoft 365 and electronic health or billing systems • Preferred: 2 or more years of experience in revenue cycle operations, pharmacy billing, or collections • Preferred: Experience working with ICD-10, CPT, HCPCS, and Medicare billing guidelines • Preferred: Knowledge of pharmacy Part D claims, CE2000, home infusion billing, and third-party payer rules • Preferred: Experience using systems such as HCN360, CPR+, or comparable billing platforms

🏖️ Benefits

• Annual bonus plan eligibility • Medical, vision, and dental benefits starting on day one • Well-being and behavioral health programs • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays • Leaves of absence • Tobacco-free policy • Home internet requirement/support for occasional or permanent work at home