Enrollment/Billing Senior Representative - Evernorth Health Services- Remote

Overview

This role supports payer solutions operations within the billing team. The Enrollment/Billing Senior Representative provides billing and collections support for new and existing accounts, manages a book of TPA business, and supports both billing and cash functions through dual training.

Responsibilities

• Manage an assigned portfolio of complex client accounts
• Perform collections-related tasks and follow collections processes and procedures
• Research and respond to billing or payment inquiries within established turnaround times; escalate issues as needed
• Work with third party administrators, brokers, and/or clients to reconcile accounts receivable
• Facilitate conference calls or meetings with internal and external parties
• Conduct extensive research related to member eligibility and rate variances
• Analyze client data using various reports and resources
• Process group renewals, new business, terms, and revisions
• Reconcile accounts on a periodic basis
• Calculate and create special charge bills as needed
• Monitor delinquency reports and send communications to TPA partners
• Participate in a peer audit process to ensure quality and mitigate financial risk or exposure
• Achieve or exceed daily goals, quality goals, and individual development goals
• Ensure appropriate use of tools to track and monitor financial performance of customers
• Work with matrix partners to resolve customer disputes and rate issues
• Partner with matrix organizations to identify and implement high-potential process improvements
• Understand and apply accounting concepts
• Prepare monthly and other requested ad hoc reporting
• Provide internal and external customer service
• Process, review, and understand multiple systems inputs
• Support special projects as needed

Billing and payment support (including cash dual-training)

• Perform electronic invoicing
• Apply financial payments to accounting systems
• Complete filing and other general administrative duties

Requirements

• High School Degree or equivalent (required); Bachelor’s degree preferred
• 3+ years of work experience in billing, accounting, or collections
• Proficient in 10-key
• Strong knowledge of Excel
• Genasys, SAP, PCRS system knowledge preferred, or ability to quickly learn new applications and systems
• Analytical skills with strong attention to detail and quality orientation
• Knowledge of MS applications
• Ability to demonstrate solid problem-solving skills
• Ability to manage time and prioritize appropriately
• Responsiveness and a sense of urgency when working with internal and external clients
• Ability to multi-task and shift priorities
• Ability to work independently and proactively
• Strong verbal and written communication skills, plus strong organizational skills
• Demonstrated leadership and motivational skills in a fast-paced environment
• Strong interpersonal skills

Preferred Qualifications

• Experience supporting member eligibility and rate variance research
• Familiarity with the interrelationships between CIGNA HealthCare matrix partners
• Experience meeting customer service deliverables (policies, cutoff dates, billing) and understanding their impact on timing and results

Compensation & Benefits

• Anticipated hourly rate: 20 - 30 USD / hour, depending on relevant factors including experience and geographic location
• Eligible to participate in an annual bonus plan
• Comprehensive benefits starting on day one, including:
  • Medical, vision, dental, and well-being and behavioral health programs
  • 401(k)
  • Company-paid life insurance
  • Tuition reimbursement
  • Minimum of 18 days of paid time off per year
  • Paid holidays
  • Leaves of absence

Location

• If working from home occasionally or permanently: internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Additional Information

• 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.
• Tobacco-free policy: the employer reserves the right not to hire tobacco/nicotine users in states where legally permissible. Candidates in such states who use tobacco/nicotine will not be considered unless they enter a qualifying smoking cessation program prior to the start of 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.