Claims Associate Representative - EviCore - Remote

EviCore, a line of business within The Cigna Group is hiring an Accounts Receivable Claims Associate. For this fast-paced demanding role, you'll be responsible for all facets of accounts receivable to ensure a complete review of outstanding balances related to a claim. The Accounts Receivable Specialist will demonstrate effective judgment when processing claims with outstanding balances. Other responsibilities may include any of the following:

What you'll do to make a difference:

• •Review, research, and process accounts receivable claims in a timely and accurate manner.
• •Investigate denied, delayed, or underpaid claims: identify root causes and take corrective actions.
• •Communicate via outbound calls with third party payers, providers and internal departments to resolve claim related issues.
• •Document all claim activity and maintain detailed records in compliance with organizational standards.
• •Monitor claim status and follow up to ensure prompt resolution and payment.
• •Escalate complex claims or unresolved issues to senior representatives or management when necessary
• •Maintain a strong understanding of payer policies, compliance requirements and company procedures.

Requirements :

• •High school Diploma or GED
• •2+ years of experience with medical claims handling and/or accounts receivable experience
• •2+ years of experience with reconciliation, analytic skills, and the ability to interpret EOBs/EOPs, highly preferred
• •Proficient in Microsoft Office Products (Word, Outlook, Excel), required
• •Able to work both independently and collaboratively with a team, required
• •Highly oriented to detail, planning and organizing skills, required
• •Ability to work in a fast-paced environment, required
• •Time management and documentation skills
• •Ability to perform basic mathematics calculations, required
• •A high level of accuracy and attention to detail

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 - 24 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 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.