Enrollment/Billing Senior Representative, Home Infusion - Evernorth- Remote

Summary

The Cigna Group is dedicated to improving the health and vitality of the people it serves through Cigna Healthcare and Evernorth Health Services. The Senior Collections Specialist supports pharmacy claim billing, collections, reimbursement, payer appeals, and accounts receivable management while improving claim accuracy, compliance, and the patient experience.

Responsibilities

• Drive timely and accurate reimbursement by actively managing pharmacy claim billing, collections, and follow‑up activities
• Resolve denied, rejected, or underpaid claims by identifying root causes and applying corrective strategies that prevent repeat issues
• Interpret explanations of benefits (EOBs) to validate reimbursement accuracy and determine next steps
• Monitor accounts receivable and take ownership of outstanding balances through persistent payer or patient outreach
• Prepare, submit, and track payer appeals within required timeframes, ensuring documentation supports favorable outcomes
• Evaluate payer rules and reimbursement guidelines to determine whether claims should be corrected, refiled, or appealed
• Ensure claim accuracy by identifying and correcting billing or submission errors that impact reimbursement
• Maintain clear, timely documentation of collection activity in patient notes and reporting tools
• Partner with teammates and leaders to identify workflow improvements that strengthen efficiency, compliance, and financial performance

Skills

• High school diploma or GED
• Minimum of 2 years of experience in collections, A/R, medical billing, healthcare claims, pharmacy billing, or insurance‑related collections
• Working knowledge of payer reimbursement processes including commercial, Medicare, Medicaid, self‑pay, and third‑party plans
• Ability to read and interpret explanations of benefits (EOBs) and billing correspondence
• Strong communication, organization, and problem‑solving skills with a customer‑focused mindset
• Proficiency in Microsoft 365 and electronic health or billing systems
• 2 or more years of experience in revenue cycle operations, pharmacy billing, or collections
• Experience working with ICD‑10, CPT, HCPCS, and Medicare billing guidelines
• Knowledge of pharmacy Part D claims, CE2000, home infusion billing, and third‑party payer rules
• Experience using systems such as HCN360, CPR+, or comparable billing platforms

Qualifications

Must Haves

• High school diploma or GED
• Minimum of 2 years of experience in collections, A/R, medical billing, healthcare claims, pharmacy billing, or insurance‑related collections
• Working knowledge of payer reimbursement processes including commercial, Medicare, Medicaid, self‑pay, and third‑party plans
• Ability to read and interpret explanations of benefits (EOBs) and billing correspondence
• Strong communication, organization, and problem‑solving skills with a customer‑focused mindset
• Proficiency in Microsoft 365 and electronic health or billing systems

Nice to Haves

• 2 or more years of experience in revenue cycle operations, pharmacy billing, or collections
• Experience working with ICD‑10, CPT, HCPCS, and Medicare billing guidelines
• Knowledge of pharmacy Part D claims, CE2000, home infusion billing, and third‑party payer rules
• Experience using systems such as HCN360, CPR+, or comparable billing platforms

Benefits

• Eligible to participate in an annual bonus plan.
• Medical, vision, dental, and well-being and behavioral health programs, offered starting on day one of employment.
• 401(k).
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays.
• Leaves of absence.
• Fully remote work arrangement.