Senior Enrollment/Billing Representative, Home Infusion

🔥 1 minute ago

🐊 Florida, North Carolina, +5 more states – Remote

🐊 Florida – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote 🤠 Texas – 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

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

• Actively manage 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 affecting reimbursement • Maintain timely 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 in delivering specialty pharmacy and infusion services

🎯 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 • Experience with 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 HCN360, CPR+, or comparable billing platforms preferred • For home work, cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload

🏖️ 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 • Remote work arrangement • Cable broadband or fiber optic internet requirement for home working