Billing & Reimbursement Senior Representative - Whitestown, Indiana

Cigna Healthcare • New Salem, IN

2d • Hybrid

About The Position

POSITION SUMMARY: 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 SHOULD INCLUDE: Must be located within driving distance of the Whitestown, Indiana office (4750 East 450 South) as this position is mainly remote/work from home, but attendance for training and meetings in-person as necessary is required (i.e. - quarterly team meetings, training, etc.). Must be able to work an 8-hour shift Monday - Friday for with flexibility to start work day between 6am - 9am EST. HS diploma or GED 3+ years relevant experience - healthcare or insurance industry highly preferred Healthcare, insurance, pharmacy knowledge highly preferred 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 require reasonable accommodation in completing the online application process, please email: [e-mail] for support. Do not email [e-mail] for an update on your application or to provide your resume as you will not receive a response. 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. 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.

Requirements

• Must be located within driving distance of the Whitestown, Indiana office (4750 East 450 South) as this position is mainly remote/work from home, but attendance for training and meetings in-person as necessary is required (i.e. - quarterly team meetings, training, etc.).
• Must be able to work an 8-hour shift Monday - Friday for with flexibility to start work day between 6am - 9am EST.
• HS diploma or GED
• 3+ years relevant experience - healthcare or insurance industry highly preferred
• Healthcare, insurance, pharmacy knowledge highly preferred
• 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.

Nice To Haves

• Healthcare, insurance, pharmacy knowledge highly preferred

Responsibilities

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED