Accounts Receivable-Claims Research And Reconciliation Processor - Evicore - Remote

Do you want to Drive Growth and Improve Lives? EviCore, a division of The Cigna Group is hiring several Accounts Receivable-Claim Research and Reconciliation Processors. For this exciting new role, you'll be responsible for research and reconciliation of highly escalated providers. The candidate must have a thorough knowledge of government, commercial, and other types of insurance billing guidelines in multiple states to demonstrate effective judgment when processing claims with outstanding balances.
What you'll do to make a difference:

• Process a variety of Third-Party Administrator (TPA) payments
• Conducting thorough research of aged for highly escalated providers
• Support and streamline provider escalated inquiries
• Analyzes and clears payment variances and complete special payment Adjustments circumstances
• Support special projects, JOC calls, and provider analytics
• Process timely premium payments to providers
• Monitors payer responses to ensure prompt payment
• Follow-up on outstanding account balances at 30-days from the date of service in accordance with client and organizational protocol with an emphasis on maximizing client satisfaction and provider profitability
• Research and answer accounts receivable discrepancies
• Research/rectify third party denials/edits, requests for information and other related correspondence
• Ability to process Coordination of Benefits
• Verify patients' eligibility, coverage, and benefits and identify authorization requirements related to working aged Accounts Receivables

What you'll need to succeed:

• Proficient with PCM, MCRS, Great Plains, MC400, ISAAC, Image One platforms, strongly preferred
• Exceptional reconciliation, analytic skills, and the ability to interpret EOBs/EOPsA
• 2+ years of experience with medical claims accounts receivable required
• Proficiency in Excel and Microsoft Office applications required
• Ability to work in a fast-paced environment
• High level of accuracy and attention to detail and have a dedicated approach to work
• 2+ years of experience with claims research, reconciliation, and Processing experience
• High school diploma or GED required
• 2+ years of experience in medical billing and/or accounts receivable required

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 - 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.
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: [email protected] for support. Do not email [email protected] 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.