Enrollment/Billing Senior Representative - Remote

About Accredo:

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.

What you will do:

• As a member of the Evernorth Finance team, you will edit, bill, and collect payment on complex and unique outstanding claims with a goal of positively impacting the company's revenue and accounts receivable balance.

• Enabled by a robust training curriculum, clear policies, and team support, you will contribute toward the important functions of billing and collections and contributing toward our growth strategy.

• To achieve our collective success, a working knowledge of the billing and collection processes and accountability for quantity and quality metrics are key expectations of the role.

• Beyond your core responsibilities, you are expected to embrace a high performance culture through teamwork, personal development, accountability, and involvement in special committees/projects.

• As a Senior Representative you may support larger and more complex accounts, research and identify accounts receivable trends, implement tactics to improve collections and communicate opportunities for best practices based on issues identified. 

• You will work without immediate supervision, but will have ready access to guidance from experienced team members.

Collections –

• Work complex collections issues to understand root cause of non-payment, focusing on steps necessary to resolve denial and secure payment

• Investigate reasons for unpaid balances from insurance companies

• Troubleshoot both internal & external issues that result in collections efforts

• Work independently to research and resolve the unpaid balance while following Evernorth policies as well as the insurance company requirements

• Identify payor issues/trends, develop and implement processes to improve results, and resolve non-routine issues escalated from less experienced team members

• Work special payor projects as necessary when challenges arise that need to be addressed in the aggregate

• Help ensure all collection efforts are exhausted before adjustments are recommended

• Collaborate effectively with internal business partners as well as external payers to drive timely and accurate collections of invoiced amounts

• Serve as a mentor for new hires on tasks associated with role

What you need to do the job:

• Ability to work Monday - Friday 9am to 5:30pm EST

• High school diploma or GED required; Associate's degree strongly preferred

• Professional experience in collections, billing, reimbursement, claims highly preferred

• Experience in healthcare, pharmacy, insurance, medical field preferred

• Accounts receivable background preferred

• Experience with RxHome or CE2000 a plus

• Proficient in Microsoft Office with working knowledge of Microsoft Excel

• Self-motivated and goal-oriented

• Independent and proactive problem-solving skills

• Ability to manage multiple priorities

• Solid written and verbal communication skills

• Strong research and analytical skills

• Team player with a positive attitude

• Detail oriented

• Solid organizational skills

• Must meet work at home company requirements, and have a strong ability to stay engaged in a virtual environment

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 20 - 30 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 progr