Billing & Claims Representative - Accredo (Remote)

POSITION SUMMARY

Delivers straightforward administrative and/or other basic business services in Enrollment/Billing. Provides financial related support for banking and/or billing related functions to new and/or existing accounts. Sets up, manages, reconciles, processes, and/or balances bank and/or customer accounts. Works with internal/external customers, banks, vendors, and/or partners to resolve issues. May create, analyze and respond to standard and/or non-standard reports. Bills and/or collects outstanding/delinquent payments or issues payments. Audits accounts for compliance. Supports mid to large markets. Issues tend to be routine in nature. Good knowledge and understanding of Enrollment/Billing and business/operating processes and procedures. Works to clearly defined procedures under close supervision.

ESSENTIAL FUNCTIONS

• Prepares and reviews claims to ensure billing accuracy.

• Pursues collection activities to obtain reimbursement from payers and/or patients.

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

• Escalates delinquent and/or complex claims to Sr. Billing & Reimbursement Specialists for appropriate action.

QUALIFICATIONS

• High School Diploma or GED Required.

• 2 + years Call Center and Medical Billing & Collections experience preferred.

• PC Skills including Microsoft Outlook, Excel, Word and Internet.

• Detail oriented and strong organizational skills.

• 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.

ABOUT THE DEPARTMENT

Through our range of health care products and services offered, Accredo team members provide in-depth care for patients with chronic health conditions like hemophilia, oncology, rheumatoid arthritis and growth hormone deficiency. In addition to health care products, we provide comprehensive management services – including outcomes measurement, counseling, clinical care management programs, social services and reimbursement services. By performing in these very high-touch roles, employees have a daily opportunity to make a positive impact on their patients’ lives.

NOTE: We are currently training in a work at home environment, and you will be required to have reliable internet connectivity provided through a wired connection.  A mobile or hot spot environment is not acceptable and you may need to purchase an Ethernet cord depending on your current set up. 

Training Hours: 8:00am - 4:30pm M/F

Working Hours: Flex start 7:00am - 9:00am M/F

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 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: [email protected] for support. Do not email [email protected] 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.