Want Accounts Receivable-Claims Research and Reconciliation Processor - eviCore - Remote in Bloomfield, CT
Job title: Accounts Receivable-Claims Research and Reconciliation Processor - eviCore - Remote
Company: Cigna
Job description: 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:
- Research/rectify third party denials/edits, requests for information and other related correspondence
- Process a variety of Third-Party Administrator (TPA) payments
- Support special projects, JOC calls, and provider analytics
- Support and streamline provider escalated inquiries
- Conducting thorough research of aged for highly escalated providers
- Ability to process Coordination of Benefits
- Analyzes and clears payment variances and complete special payment Adjustments circumstances
- Verify patients' eligibility, coverage, and benefits and identify authorization requirements related to working aged Accounts Receivables
- 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
- Process timely premium payments to providers
- Research and answer accounts receivable discrepancies
- Monitors payer responses to ensure prompt payment
- High school diploma or GED required
- 2+ years of experience in medical billing and/or accounts receivable required
- 2+ years of experience with medical claims accounts receivable required
- 2+ years of experience with claims research, reconciliation, and Processing experience
- Proficiency in Excel and Microsoft Office applications required
- Proficient with PCM, MCRS, Great Plains, MC400, ISAAC, Image One platforms, strongly preferred
- Ability to work in a fast-paced environment
- Exceptional reconciliation, analytic skills, and the ability to interpret EOBs/EOPsA
- high level of accuracy and attention to detail and have a dedicated approach to work