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Senior Enrollment/Billing Representative, Home Infusion
The Cigna Group. Drive timely and accurate reimbursement by managing pharmacy claim billing, collections, and follow-up activities .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing pharmacy claim billing and collections, with a strong focus on reimbursement accuracy and compliance. Proficient in interpreting EOBs and navigating payer reimbursement processes to optimize financial performance.
Highest-signal resume keywords
Pharmacy BillingClaims ManagementPayer Reimbursement ProcessesEOB InterpretationRevenue Cycle Operations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingCollectionsAccounts ReceivableICD-10CPTHCPCSPayer AppealsBilling CorrectionsDocumentation ManagementWorkflow Improvement
Soft Skills
Strong CommunicationOrganizationProblem-SolvingCustomer-Focused Mindset
Tools & Technologies
Microsoft 365Electronic Health SystemsBilling SystemsHCN360CPR+
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Healthcare ClaimsMedicareMedicaidThird-Party PlansPharmacy Part D ClaimsHome Infusion Billing
About the role
Key responsibilities & impact- Drive timely and accurate reimbursement by managing pharmacy claim billing, collections, and follow-up activities
- Resolve denied, rejected, or underpaid claims by identifying root causes and applying corrective strategies
- Interpret explanations of benefits (EOBs) to validate reimbursement accuracy and determine next steps
- Monitor accounts receivable and manage outstanding balances through payer or patient outreach
- Prepare, submit, and track payer appeals within required timeframes
- Evaluate payer rules and reimbursement guidelines to determine whether claims should be corrected, refiled, or appealed
- Identify and correct billing or submission errors impacting reimbursement
- Maintain documentation of collection activity in patient notes and reporting tools
- Partner with teammates and leaders to identify workflow improvements that strengthen efficiency, compliance, and financial performance
- Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization
Requirements
What you’ll need- High school diploma or GED
- Minimum of 2 years of experience in collections, A/R, medical billing, healthcare claims, pharmacy billing, or insurance-related collections
- Working knowledge of payer reimbursement processes including commercial, Medicare, Medicaid, self-pay, and third-party plans
- Ability to read and interpret explanations of benefits (EOBs) and billing correspondence
- Strong communication, organization, and problem-solving skills with a customer-focused mindset
- Proficiency in Microsoft 365 and electronic health or billing systems
- Preferred: 2 or more years of experience in revenue cycle operations, pharmacy billing, or collections
- Preferred: Experience working with ICD-10, CPT, HCPCS, and Medicare billing guidelines
- Preferred: Knowledge of pharmacy Part D claims, CE2000, home infusion billing, and third-party payer rules
- Preferred: Experience using systems such as HCN360, CPR+, or comparable billing platforms
Benefits
Comp & perks- Annual bonus plan eligibility
- Medical, vision, and dental benefits starting on day one
- Well-being and behavioral health programs
- 401(k)
- Company-paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
- Tobacco-free policy
- Home internet requirement/support for occasional or permanent work at home