- Audit claims in accordance with policy terms / conditions and company quality standards and procedures
- Achieve / exceed set productivity and quality standards
- Interface effectively with internal staff to resolve customer issues
- Maintain accurate records and files as required
- Actively support other team members and the achievement of team objectives
- Identify potential process improvements and make recommendations to Supervisor
- High School Diploma or GED, required
- 2+ years demonstrated experience analyzing and resolving customer problems, required
- 2+ years of experience with accurate data entry and computer proficiency with Microsoft products (Excel, Outlook, Word)
- 2 + years of knowledge of claims processes and Medical Terminology, required
- 1+ years of Medicare claims processing experience strongly preferred
- 1+ years of experience with Plexis, Report Manager (SQL Report Server), ISAAC, and MedSolutions experience a PLUS
- 1+ years of experience with Accounts Receivable is preferred
- Ability to perform in a high volume, fast paced claims environment
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Accounts Receivable - Remote, United States - The Cigna Group
Description
Do you want to drive growth and improve lives? EviCore, a division of The Cigna Group is hiring an Accounts Receivable - Quality Assurance, Claims Auditor. For this integral role you will audit / examine claims to verify their accuracy in accordance to the claim application, provider statement, policy file and other records to evaluate completeness and validity of claim. You'll Interact with agents to correct claim form errors or omissions and to investigate questionable entries. Completes day-to-day tasks without immediate supervision but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues.
What you'll do to make a difference:
What you'll need to succeed:
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That's why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
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: for support. Do not email 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.
