Patient Pay Collector - Evernorth - Remote

Cigna•Jacksonville, FL

5d•$18 - $26•Remote

About The Position

Are you energized by helping others and solving complex challenges? Join Evernorth's CarepathRx Revenue Cycle Team as a Patient Pay Collector and play a vital role in ensuring patients receive the support they need while driving timely reimbursement. You'll collaborate with compassionate experts, leverage your problem-solving skills, and make a meaningful impact on our mission to improve healthcare outcomes. 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. For this position, we anticipate offering an hourly rate of 17.75 - 26 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. 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.

Requirements

High school diploma or GED equivalent.
Minimum 1 year of experience in collections, medical billing, or a related team-oriented environment.
Strong customer service and communication skills.
Excellent organizational and problem-solving abilities.
Ability to work independently and collaboratively within a team.

Nice To Haves

2+ years of experience in medical billing, collections, or administrative record management.
Experience with home infusion, insurance policies, and reimbursement procedures.
Familiarity with ICD9, CPT4, HCPCS, and medical terminology.
Knowledge of third-party payer guidelines and financial resources for patient balances.
Medicare billing experience (DMEMAC HCN360 and CPR+ systems).

Responsibilities

Drive successful collection of insurance claims and patient balances, ensuring timely and accurate reimbursement.
Analyze claim denials, identify root causes, and recommend solutions to prevent future issues.
Meet and exceed quality assurance and productivity benchmarks, contributing to team success.
Initiate proactive communication with payers and patients to resolve outstanding balances and facilitate positive outcomes.
Document all collection activities and communications with clarity and accuracy.
Process payer appeals, claim adjustments, and denials, determining appropriate next steps for resolution.
Review patient information to validate adjustments and confirm approval requirements.
Interpret Explanation of Benefits (EOBs) and reimbursement contracts to resolve claims.
Maintain confidentiality and discretion when handling sensitive information.
Contribute to continuous improvement by identifying opportunities to streamline processes and enhance patient experience.