Enrollment/Billing Senior Representative - Village Fertility Pharmacy - Hybrid - Scottsdale, AZ (Finance)
Role Overview:
The Enrollment/Billing Senior Representative works under the direction of the Manager of RCM to maintain the accuracy of Village Fertility Pharmacy's Accounts Receivable balances to ensure accuracy and timeliness of balances.
Essential Functions:
- Coordinates billing and collection across multiple payors.
- Utilizes knowledge of accounting and pharmacy systems to ensure proper posting and reconciliation of payments across multiple payors.
- Downloads reports from multiple portal locations daily/weekly as assigned.
- Downloads Leadernet reports daily and send to TPMS.
- Downloads credit card payments daily and assist with reconciliation of payments.
- Works directly with the shipping and scheduling teams to ensure front-end accuracy on completion of orders.
- Maintains multiple email boxes, instant messages, and communications with operations team on billing issues.
- Posts manual payments for patient accounts and handles patient account issues.
- Performs necessary investigation and collection procedures required to keep accounts receivable balances current & accurate.
- Communicates adjustments and reconciliations with finance department to enable accurate financial reporting.
- Works proactively with patients to educate them about their account balances, process payments and facilitate their questions.
- Creates invoices and history reports as needed and requested.
- Processes monthly patient account statements and invoices.
- Determines required adjustments to billed claims and adjusts claims as needed on a timely basis based on existing policy and procedures and reports them to Manager and Lead Analyst for processing.
- Reviews aging reports for clinic billing and patient accounts regularly.
- Reconciles credit card payments for multiple locations to pharmacy systems.
- Processes credit card payments as needed for office and patient payments due.
- Assists operations team with weekly claims reversals as needed.
- Assists accounting team with tasks as needed.
- Performs other duties and responsibilities as needed.
Requirements:
- Must be local to Scottsdale, AZ as training will be onsite followed by a hybrid schedule of 3 days onsite, 2 days remote
- Must be able to able to work an 8 hour shift Monday - Friday within this timeframe: 7:30am - 5pm MST
- HS diploma or GED required
- Experience in healthcare setting working in insurance and/or patient billing preferred
- 1+ year experience in specialty office, medical billing, or pharmacy preferred
- Proficient computer skills including all Microsoft programs
- Experience with accounts receivable & reconciliation functions preferred
- Basic knowledge of medical terminology, as well as a baseline understanding of specialty medications
- In-depth knowledge of insurance coverage, terminology, and benefit investigation
- Able to communicate coverage details to patients and providers
- Ability to exercise judgment under pressure and use analytical ability to affect solutions
- Ensure that customers have a positive experience; commits to meet customer expectations
- Have effective communication, people, and organizational skills (verbal and written)
- Be flexible to help with other jobs as needed
- Capability to multitask is essential without sacrificing quality and attention to detail
- Ability to thrive in a fast-paced environment/ growing business with daily and weekly deadlines
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.
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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
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.
