Medical Collections Specialist, Home Infusion

Job not on LinkedIn

🔥 23 hours ago

🐊 Florida, Texas, +1 more states – Remote

🐊 Florida – Remote 🤠 Texas – Remote 🍑 Georgia – Remote

⏰ Full Time

🟢 Junior

📞 Collections

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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• No salary listed.

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Collect on insurance claims and move unpaid accounts toward timely resolution • Research denials, rejections, and payment issues to identify root causes and recommend preventive steps • Submit payer appeals within required time frames with clear supporting documentation • Review patient account details, claim status, and explanations of benefits to determine correction, refiling, adjustment, or appeal actions • Investigate claims and payer contracts to confirm payment accuracy and identify reimbursement gaps • Consider home infusion billing requirements where applicable • Communicate with patients, payers, outside agencies, and internal partners • Document collection activity, account actions, and outcomes in patient notes, AR Aging Reports, and Over/Under Reports • Track account trends and share insights supporting process improvements and stronger collections • Meet quality, productivity, and service standards while working independently and collaboratively

🎯 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 • Must be eligible to work in this country • Home infusion billing or collections experience is strongly preferred • 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 • Knowledge of financial resources or payment assistance options that support patient account resolution • Home internet via cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload when working at home

🏖️ Benefits

• Remote work / work at home • Monday-Friday schedule, 8:00 a.m.-4:30 p.m. ET • Equal employment opportunity • Reasonable accommodation support for the application process • Tobacco-free policy • Drug-free work environment

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