Billing & Reimbursement Senior Representative - Whitestown, IN

POSITION SUMMARY:

This position is mainly remote/work from home, but attendance for training and meetings in-person in Whitestown, Indiana as necessary is required.

Schedule: Monday - Friday for 8-hour shift with flexibility to start workday between 6am - 9am EST.

Join our team our Accounts Receivable team that supports our Specialty Pharmacy - Accredo, as a Billing & Reimbursement Senior Representative.

In this role, you will utilize advanced knowledge to prepare and review claims approaching timely filing to ensure billing accuracy and to edit, bill and collect payment on outstanding claims in pursuit of reducing the company's accounts receivable.

The qualified candidate must have a complete understanding of the billing and collection processes and require little supervision for routine work.

ESSENTIAL FUNCTIONS:


* Prepares and reviews claims to ensure billing accuracy according to payor requirements, including but not limited to codes, modifiers, pricing, dates and authorizations


* Pursues collection activities to obtain reimbursement from patients and/or payors


* Contacts payor to request overrides, retro authorizations, additional documentation, window extensions, etc.

to ensure invoice has necessary elements for reimbursement or to work a rejected claim (denial)


* Frequent follow up with payers and/or patients on outstanding accounts


* Responds to billing inquiries and questions relating to patient accounts


* Helps with special projects when needed

QUALIFICATIONS:


* Must be local to Whitestown, IN & willing and able to come onsite as needed for training and meetings


* Must be able to work an 8 hour shift Monday - Friday with flexibility to start workday between 6am - 9am EST


* HS diploma or GED required


* 3+ years relevant experience - healthcare or insurance industry highly preferred


* Healthcare, insurance, pharmacy knowledge highly preferred


* PC Skills including Microsoft Outlook, Excel, Word


* Strong written & verbal communication skills


* Strong critical thinking & investigative skills


* Detail oriented and strong organizational skills


* Self-starter and team player


* Focus on quality and service


* Demonstrated ability to meet multiple deadlines and manage a heavy workload


* Integrity to handle sensitive or confidential information is critical

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.

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 gro...