The Cigna Group
CollectionsSpecialist
“Collections Specialist at The Cigna Group. Skills: Collections, Billing, Patient Accounts Management, Payment Resolution, Microsoft 365. Managing Self-Pay Collections. ensuring timely and accurate payment of claims”
What You'll Achieve.
reducing outstanding balances; maximizing reimbursement; prevent further adjustments; support resolution and prevent future issues; highlight opportunities for improvement; Ensure all work meets quality assurance and benchmark standards
Industry & Context.
critical thinking skills; effective critical thinking skills; resolving discrepancies; resolving payment and billing issues; support resolution and prevent future issues
What They're Looking For.
Must Have
High school diploma or equivalent, Knowledge of Microsoft 365 products, including but not limited to Outlook, Teams, and Excel, Minimum of 1–2 years of experience in billing, collections, or related field, Excellent interpersonal, organizational, communication and effective critical thinking skills, customer service, Maintain confidentiality and practice discretion and caution when handling sensitive information, Ability to read and interpret an EOB for accurate understanding of claim processing
Nice to Have
HCN360 and CPR+ knowledge, Experience with ICD-10, CPT-4, HCPCS, and medical terminology, Familiarity with third party payor guidelines and reimbursement practices and available financial resources for payment of balances due, Prior knowledge of home infusion
What You'll Do.
Managing Self-Pay Collections
ensuring timely and accurate payment of claims
handling in-bound patient calls
reviewing co-pay assistance claims
investigating accuracy and account review with the goal of resolving discrepancies and maximizing reimbursement
Support accurate and timely billing and collections to reduce outstanding balances
Manage assigned book of business: Transfer of balance due
charging of patient ACH and Credit Card and one-time credit cards for copay assistance payments
and contractual adjustments requests of accounts
Contacting patients or payers as appropriate
Review accounts with patients and resolve questions or transfer to appropriate staff member
Partner with copay assistance programs and internal teams to resolve payment and billing issues
Review claim processing to determine proper payment has been issued
Accurately identify adjustments needed and take proper action to prevent further adjustments
Identify trends or payment challenges and take action to support resolution and prevent future issues
Review and analyze reports to track account activity and highlight opportunities for improvement
Ensure all work meets quality assurance and benchmark standards set by the management team
Work independently and as part of a team
Documents all collections activity in patient collections notes and AR Reports
Review patient unapplied account and verify accuracy of payment prior to posting to the correct open account receivable
How You'll Work.
Team & Collaboration
Work independently and as part of a team; Partner with copay assistance programs and internal teams to resolve payment and billing issues
Communication Scope
communication; communication skills
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