Job Description
The Payer Solutions Operations billing team is seeking an Enrollment/Billing Representative who will be responsible for providing billing and collections support to new and existing accounts and will manage a book of TPA business with responsibility for tasks such as: reconciling group accounts, creating special charge invoices, researching payment and census issues, requesting refunds, and tracking and resolving delinquency issues. Works with internal/external customers, banks, vendors, and/or partners to resolve matters. May create, analyze and respond to standard and/or non-standard reports. Must have experience working in Excel and be proficient with 10-key in both speed and accuracy. In addition, incumbent will be dual trained to provide support for the cash team. Duties may include cash and census application, mailings, filing, electronic invoicing and general support. May work with internal/external customers, banks, vendors, and/or partners to resolve matters. May create, analyze and respond to standard and/or non-standard reports.
Responsibilities:
Manage assigned portfolio of complex client accounts
Perform tasks related to collections processes and procedures
Research/respond to billing or payment inquiries within established turnaround times. Escalate issues as needed.
Work with third party administrators, brokers and/or clients directly to reconcile accounts receivable
Facilitates conference calls or meetings with internal and external parties
Extensive research related to member eligibility and rate variances
Analyze client data utilizing various reports and resources
Process group renewals, new business, terms and revisions
Account reconciliation on a periodic basis
Calculate and create special charge bills as needed
Monitor delinquency reports and send communication to TPA partners
Peer audit process to ensure quality and mitigate financial risk or exposure
Responsible for achieving or exceeding daily goals, quality goals, and individual development
Ensures appropriate use of tools to track and monitor the financial performance of customers
Work with matrix partners to resolve customer disputes and rate issues
Partners with matrix organizations to ensure that appropriate action is taken to identify and implement high potential process improvements
Understand and use accounting concepts
Prepare monthly and other requested ad hoc reporting
Provide both internal and external customer service
Process, review and understand multiple systems inputs
Special project support as needed
Electronic Invoicing
Application of financial payments to accounting systems
Filing and other general administrative duties
Account reconciliation on a periodic basis
Knowledge/understanding of the interrelationships between CIGNA HealthCare matrix partners.
Understanding of customer service deliverables (policies, cutoff dates, billing) and their impact on timing and results.
Qualifications:
High School Diploma or equivalent experience is required; Bachelor's degree preferred.
3+ years work experience in billing, accounting, or collections role
Proficient in 10 keys
Strong knowledge of Excel
Genasys, SAP, PCRS system knowledge preferred, or quick learner of new applications and systems
Analytical, attention-to-detail, and quality-oriented
Knowledge of MicroSoft applications
Ability to demonstrate solid problem solving skills
Demonstrate ability to manage time and prioritize appropriately
Demonstrates responsiveness and a sense of urgency when dealing with internal and external clients
Ability to multi-task and shift priorities
Demonstrate strength and understanding of customer expectations and "sense of urgency" resulting in the ability to influence the organization to meet and exceed customer expectations.
Ability to work independently and pro-actively
Strong verbal/written communication and organizational skills to effectively communicate and interact with all levels and functions within the organization.
Demonstrate leadership and motivational skills in fast-paced environment.
Strong interpersonal skills.
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 programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here (https://jobs.thecignagroup.com/us/en/benefits) .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
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.
