Enrollment/Billing Senior Representative- Evernorth Health Services – Remote Fulltime

The job profile for this position is Enrollment/Billing Senior Representative, which is a Band 2 Professional Career Track Role.

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We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

SUMMARY:

This position is remote/work from home, but attendance for training and meetings in-person as necessary is required.
Join our team our Accounts Receivable team that supports our specialty pharmacy – Accredo, as a Billing & Reimbursement Senior Representative. In this role, you will utilize advanced knowledge to prepare and review claims approaching timely filing to ensure billing accuracy and to edit, bill and collect payment on outstanding claims in pursuit of reducing the company’s accounts receivable. The qualified candidate must have a complete understanding of the billing and collection processes and require little supervision for routine work.

ESSENTIAL FUNCTIONS:
• Prepares and reviews claims to ensure billing accuracy according to payor requirements, including but not limited to codes, modifiers, pricing, dates and authorizations.
• Pursues collection activities to obtain reimbursement from payors and/or patients. Contacts payor to request overrides, retro authorizations, additional documentation, window extensions, etc. to ensure invoice has necessary elements for reimbursement or to work a rejected claim (denial).
• Frequent follow up with payers and/or patients on outstanding accounts.
• Responds to billing inquiries and questions relating to patient accounts.
• Helps with special projects when needed.

QUALIFICATIONS
• HS Degree (or equivalent).
• 3-5 years relevant experience.
• PC Skills including Microsoft Outlook, Excel, Word and Internet
• Detail oriented and strong organizational skills.
• Self-starter and team player.
• Focus on quality and service.
• Demonstrated ability to meet multiple deadlines and manage a heavy workload.
• Integrity to handle sensitive or confidential information is critical.

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.

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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

Tagged as: Representative