Billing & Reimbursement Senior Representative

POSITION SUMMARY:

• Must be located within driving distance of the Whitestown, Indiana office as this position is mainly remote/work from home, but attendance for training and meetings in-person as necessary is required.
• Must be able to work Monday - Friday for an 8-hour shift with flexibility to start workday between 6am - 9am EST.

Join our team our Accounts Receivable team that supports our Specialty Pharmacy - Accredo, as a Billing & Reimbursement Representative. In this role, you will utilize advanced knowledge to prepare and review claims approaching timely filing to ensure billing accuracy and to edit, bill and collect payment on outstanding claims in pursuit of reducing the company's accounts receivable. The qualified candidate must have a complete understanding of the billing and collection processes and require little supervision for routine work.

ESSENTIAL FUNCTIONS:

• Prepares and reviews claims to ensure billing accuracy according to payor requirements, including but not limited to codes, modifiers, pricing, dates and authorizations
• Pursues collection activities to obtain reimbursement from patients and/or payors
• Contacts payor to request overrides, retro authorizations, additional documentation, window extensions, etc. to ensure invoice has necessary elements for reimbursement or to work a rejected claim (denial)
• Frequent follow up with payers and/or patients on outstanding accounts
• Responds to billing inquiries and questions relating to patient accounts
• Helps with special projects when needed

QUALIFICATIONS:

• Must be local to Whitestown, Indiana & willing and able to come onsite as needed for training and meetings
• Must be able to work an 8 hour shift Monday - Friday with flexibility to start workday between 6am - 9am EST
• High school diploma or GED required
• Experience and knowledge in healthcare, insurance, or pharmacy industry highly preferred
• Collections, billing, reimbursement, payment processing experience a plus
• PC Skills including Microsoft Outlook, Excel, Word
• Strong written & verbal communication skills
• Strong critical thinking & investigative skills
• Detail oriented and strong organizational skills
• Self-starter and team player
• Focus on quality and service
• Demonstrated ability to meet multiple deadlines and manage a heavy workload
• Integrity to handle sensitive or confidential information is critical

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email [email protected] for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.