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.
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.
Qualifications
Required
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.
Preferred
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).
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.
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.