Collections Specialist- Evernorth- Remote
About The Position
As a vital member of our revenue operations team, you will play a key role in ensuring accurate claim processing, timely reimbursement, and a positive financial experience for patients and payers. You will investigate denials, resolve payment discrepancies, and strengthen collection practices that directly support our mission to deliver efficient, patient-centered financial services. As part of Evernorth Health Services, this role supports CarepathRx within our Pharmacy and Care Delivery organization. Our team focuses on specialty pharmacy and infusion services in partnership with hospitals and health systems.
Requirements
- High school diploma or equivalent
- Minimum 1+ years of experience in collections, medical billing, or revenue cycle operations.
- Ability to read and interpret EOBs and understand payer reimbursement practices.
- Strong communication, organizational, and problem-solving skills.
- Proficiency with Microsoft 365.
- 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
- Experience with ICD-10, CPT-4, HCPCS, and Medicare billing.
- Knowledge of home infusion, reimbursement guidelines, and third-party payer rules.
- Familiarity with HCN360, CPR+, or similar systems.
Responsibilities
- Manage third-party billing and collections, ensuring timely and accurate processing of claims and appeals.
- Investigate denials and rejections to identify root causes and recommend actions that prevent repeat issues.
- Review claim processing to confirm proper payment and pursue corrective steps when discrepancies arise.
- Process payer appeal requests within required timeframes and track outcomes.
- Contact payers or patients, as appropriate, to resolve outstanding issues.
- Document all collections activity in patient notes and accounts receivable reports.
- Evaluate payer guidelines to determine whether claims should be corrected, refiled, or appealed.
- Interpret EOBs to validate payment accuracy and guide next steps.
- Identify and correct claim errors to support full reimbursement.
- Support continuous improvement by identifying workflow enhancements that strengthen financial performance.
Benefits
- At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
- We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
- For more details on our employee benefits programs, click here.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
