Collections Specialist- Evernorth at The Cigna Group

, , United States -

Full Time

Start Date

Immediate

Expiry Date

25 Mar, 26

Salary

25.0

Posted On

25 Dec, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Collections, Medical Billing, Revenue Cycle Operations, EOB Interpretation, Communication Skills, Organizational Skills, Problem-Solving Skills, Microsoft 365, ICD-10, CPT-4, HCPCS, Medicare Billing, Home Infusion, Reimbursement Guidelines, Third-Party Payer Rules

Industry

Hospitals and Health Care

Description

As a vital member of our revenue operations team, you will play a key role in ensuring accurate claim processing, timely reimbursement, and a positive financial experience for patients and payers. You will investigate denials, resolve payment discrepancies, and strengthen collection practices that directly support our mission to deliver efficient, patient-centered financial services. Responsibilities Manage third-party billing and collections, ensuring timely and accurate processing of claims and appeals. Investigate denials and rejections to identify root causes and recommend actions that prevent repeat issues. Review claim processing to confirm proper payment and pursue corrective steps when discrepancies arise. Process payer appeal requests within required timeframes and track outcomes. Contact payers or patients, as appropriate, to resolve outstanding issues. Document all collections activity in patient notes and accounts receivable reports. Evaluate payer guidelines to determine whether claims should be corrected, refiled, or appealed. Interpret EOBs to validate payment accuracy and guide next steps. Identify and correct claim errors to support full reimbursement. Support continuous improvement by identifying workflow enhancements that strengthen financial performance. Required Qualifications High school diploma or equivalent. Minimum 1+ years of experience in collections, medical billing, or revenue cycle operations. Ability to read and interpret EOBs and understand payer reimbursement practices. Strong communication, organizational, and problem-solving skills. Proficiency with Microsoft 365. Preferred Qualifications Experience with ICD-10, CPT-4, HCPCS, and Medicare billing. Knowledge of home infusion, reimbursement guidelines, and third-party payer rules. Familiarity with HCN360, CPR+, or similar systems. 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 17.75 - 25 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 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.

Responsibilities

The Collections Specialist will manage third-party billing and collections, ensuring timely and accurate processing of claims and appeals. They will also investigate denials, resolve payment discrepancies, and strengthen collection practices.