Medical Billing Representative- Evernorth -Remote
About The Position
We are seeking a dedicated Enrollment/Billing Representative to join our Revenue Cycle Team. This role is responsible for accurate and timely billing, insurance claims processing to ensure optimal reimbursement and compliance. 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. 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.
Requirements
- High school diploma or GED required.
- At least 1 year of related experience in medical billing, collections, health care, clinical setting, pharmacy, or administrative record management.
- Excellent communication skills
- Ability to interact professionally with patients, payors, and agencies via phone, email, and written correspondence.
- Understanding of third-party payor guidelines and reimbursement practices.
- Proficiency in Microsoft Office
- Strong organizational, time-management, and problem-solving skills.
- Ability to maintain confidentiality and handle sensitive information with discretion.
- Detail-oriented with the ability to multi-task and perform basic math calculations accurately.
- Self-motivated and capable of working independently or as part of a team.
Nice To Haves
- Strong customer service background preferred.
- Knowledge of Home Infusion, insurance policies, and medical billing practices highly desired.
- Familiarity with ICD-10, CPT, HCPCS codes, and medical terminology preferred.
- Knowledge of HCN 360, CareTend, and/or CPR+ is a plus.
- Medicare billing knowledge specific to DME preferred.
Responsibilities
- Understand and apply Third-Party Billing guidelines.
- Identify root causes of claim denials and recommend corrective actions to prevent recurrence.
- Ensure accuracy and timeliness of billing processes.
- Meet quality assurance standards and productivity benchmarks set by management.
- Process patient and insurance information updates.
- Handle Home Infusion/Nursing claims.
- Identify billing trends and escalate issues as needed.
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.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
