Collections Specialist, Specialty- Evernorth- Remote
About The Position
The Collections Specialist (Enrollment & Billing Representative) supports Patient Billing and Reimbursement for Home Infusion within Evernorth and CarepathRx. The role focuses on improving reimbursement outcomes, resolving billing challenges, strengthening patient accounts, and helping ensure accurate claims, timely payments, and access to care. The position works with payers, patients, and internal teams to resolve account balances and billing issues, while meeting quality and productivity goals. The listed schedule is Monday through Friday, either 8:00 a.m.–4:30 p.m. or 8:30 a.m.–5:00 p.m. ET. For work performed at home, the internet connection must be provided through cable broadband or fiber and support speeds of at least 10 Mbps download and 5 Mbps upload. The anticipated hourly rate is $17.75–$26, depending on relevant factors such as experience and geographic location. The role is anticipated to be eligible for an annual bonus plan.
Requirements
- High school diploma or GED.
- At least 1 year of experience with home infusion or specialty pharmacy medical billing or claims.
- Strong customer service skills.
- Problem-solving and critical-thinking skills.
- Clear communication skills.
- Strong attention to detail.
- Proficiency with Microsoft 365.
- Ability to work independently and as part of a team.
Nice To Haves
- Strong understanding of billing workflows.
- Knowledge of ICD-10, CPT, and HCPCS.
- Medicare billing knowledge.
- Experience reviewing payer contracts.
- Familiarity with reimbursement guidelines.
- Experience with HCN360 or CPR+.
Responsibilities
- Drive timely and accurate reimbursement through billing and collections.
- Investigate denials, identify root causes, and resolve issues.
- Submit payer appeals within deadlines and improve approval rates.
- Analyze accounts receivable and reduce payment delays.
- Partner with payers, patients, and teams to resolve balances.
- Clearly document activities, adjustments, and updates.
- Review claims to confirm correct reimbursement.
- Correct and reprocess claims to optimize payment.
- Interpret EOBs to guide next steps.
- Improve processes to reduce denials.
- Meet quality and productivity goals.
Benefits
- Medical, vision, and dental benefits starting on the first day of employment.
- Well-being and behavioral health programs.
- 401(k).
- Company-paid life insurance.
- Tuition reimbursement.
- At least 18 days of paid time off per year.
- Paid holidays.
- Leaves of absence.
- Eligibility to participate in an annual bonus plan is anticipated.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
