Medical Billing Rep -Enrollment/Billing Representative
Summary
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.
Essential Duties and 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.
Education and Experience
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.
Strong customer service background preferred.
Skills, Knowledge, and Abilities
Excellent communication skills
Ability to interact professionally with patients, payors, and agencies via phone, email, and written correspondence.
Knowledge of Home Infusion, insurance policies, and medical billing practices highly desired.
Familiarity with ICD-10, CPT, HCPCS codes, and medical terminology preferred.
Understanding of third-party payor guidelines and reimbursement practices.
Proficiency in Microsoft Office; knowledge of HCN 360, CareTend, and/or CPR+ is a plus.
Medicare billing knowledge specific to DME preferred.
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.
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. For more details on our employee benefits programs, click here ( .
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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.
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