Collections Specialist, Specialty- Evernorth- Remote

Job Description

Collections Specialist (Enrollment & Billing Representative)- Evernorth  

Patient Billing and Reimbursement -Home Infusion

Join a team that is passionate about making healthcare work better for patients and providers. As a Collections Specialist, you will improve reimbursement outcomes, resolve billing challenges, and strengthen patient accounts. Your work helps ensure accurate claims, faster payments, and better access to care. We value curiosity, teamwork, and continuous growth. 

Hours: Monday-Friday, 8:00am- 4:30pm or 8:30am-5:00pm ET

Responsibilities (What You’ll Achieve) 

• Drive timely and accurate reimbursement through billing and collections 

• Investigate denials, identify root causes, and resolve issues 

• Submit payer appeals within deadlines and improve approval rates 

• Analyze accounts receivable and reduce payment delays 

• Partner with payers, patients, and teams to resolve balances 

• Document all activities, adjustments, and updates clearly 

• Review claims to confirm correct reimbursement 

• Correct and reprocess claims to optimize payment 

• Interpret EOBs to guide next steps 

• Improve processes to reduce denials 

• Meet quality and productivity goals 

Qualifications 

Required Qualifications 

• High school diploma or GED

• 1+ years of experience with home infusion or specialty pharmacy medical billing/claims

• Strong customer service skills 

• Problem-solving and critical thinking skills 

• Clear communication skills 

• Strong attention to detail 

• Microsoft 365 proficiency 

• Ability to work independently and on a team 

Preferred Qualifications 

• Strong understanding of billing workflows 

• Knowledge of ICD-10, CPT, HCPCS 

• Medicare billing knowledge 

• Experience reviewing payer contracts 

• Familiarity with reimbursement guidelines 

• Experience with HCN360 or CPR+ 

About Evernorth and CarepathRx

As part of Evernorth Health Services, this role supports CarepathRx within our Pharmacy and Care Delivery organization. Our teams are ambitious, compassionate experts who partner with hospitals and health systems to advance specialty pharmacy and infusion services. Everything we do is centered on improving patient outcomes—together.

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 - 26 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.

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 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.