Patient Pay Collector - Evernorth - Remote

📋 Description

• • As a Patient Pay Collector within Evernorth's CarepathRx Revenue Cycle Team, you will be at the forefront of ensuring patients receive the necessary support while driving the timely and accurate reimbursement of outstanding balances. This remote role offers a unique opportunity to leverage your problem-solving acumen and customer service skills to make a tangible impact on healthcare outcomes.
• • Your primary responsibility will be to meticulously manage and collect on insurance claims and patient balances. This involves a proactive approach to identifying, analyzing, and resolving any discrepancies or denials that arise, ensuring that Evernorth receives appropriate compensation for services rendered.
• • You will be tasked with analyzing claim denials to pinpoint their root causes. This analytical component is crucial for developing and implementing effective solutions that prevent similar issues from recurring, thereby optimizing the revenue cycle.
• • A key aspect of this role is meeting and exceeding established quality assurance and productivity benchmarks. Your contributions will directly impact the team's overall success and efficiency in managing patient accounts.
• • Initiating proactive and clear communication with both payers and patients is paramount. This involves engaging in conversations to resolve outstanding balances, providing necessary information, and facilitating positive financial outcomes for all parties involved.
• • Maintaining accurate and detailed documentation of all collection activities and communications is essential. This ensures a clear audit trail and facilitates efficient follow-up and problem-solving.
• • You will process payer appeals, claim adjustments, and denials, exercising sound judgment to determine the most appropriate next steps for resolution. This requires a thorough understanding of insurance processes and Evernorth's policies.
• • A critical part of the role involves reviewing patient information to validate any requested adjustments and confirm that all necessary approval requirements have been met, ensuring compliance and accuracy.
• • Interpreting Explanation of Benefits (EOBs) and understanding reimbursement contracts will be a core function, enabling you to effectively resolve complex claims and ensure correct payment.
• • Upholding the highest standards of confidentiality and discretion when handling sensitive patient financial and health information is non-negotiable, aligning with all privacy regulations.
• • You will actively contribute to a culture of continuous improvement by identifying opportunities to streamline existing processes, enhance the patient experience, and improve overall revenue cycle efficiency.
• • This role is integral to the CarepathRx mission, supporting specialty pharmacy and infusion services in partnership with hospitals and health systems, and contributing to Evernorth's broader goal of improving health and vitality.
• • The position requires a strong understanding of medical billing and collections principles, with a focus on patient accounts and third-party payer interactions.
• • You will be expected to work independently, managing your workload effectively, while also collaborating seamlessly with team members to achieve collective goals.
• • Problem-solving will be a daily activity, requiring you to think critically and creatively to overcome obstacles in the collection process.
• • The ability to adapt to evolving insurance policies and healthcare regulations is important for sustained success in this dynamic field.
• • This role offers the chance to develop expertise in a specialized area of healthcare revenue cycle management, contributing to a vital function within a leading health services organization.
• • You will be empowered to take ownership of your accounts, driving them to resolution with a focus on both financial recovery and patient satisfaction.
• • The remote nature of this position requires strong self-discipline, effective time management, and the ability to maintain productivity without direct supervision.
• • You will be part of a supportive team environment, where knowledge sharing and collaboration are encouraged to ensure collective success.
• • This position offers a competitive hourly rate and eligibility for an annual bonus plan, reflecting the value placed on your contributions.
• • The role provides an excellent opportunity to grow within The Cigna Group, a company committed to improving health and vitality for its customers, clients, and patients.
• • You will be instrumental in ensuring financial stability for the organization while simultaneously supporting patients through potentially challenging financial periods related to their healthcare.
• • The ability to clearly and concisely communicate complex financial information to patients and payers is a key skill that will be honed in this role.
• • You will gain valuable experience in navigating the intricacies of the healthcare payment system, from initial billing to final resolution of outstanding balances.
• • This position is ideal for individuals who are detail-oriented, possess strong analytical skills, and are driven by a desire to help others and achieve positive outcomes.