Job Description

As a Data Entry Senior Representative, you would be responsible for processing overpayments in the refund and recovery department. This is a great opportunity to learn a lot about the healthcare administrative and financial aspects of claims repayments and offers opportunities for personal and professional growth.How youll make a difference in this role:

• Delivers specific delegated Data Entry tasks assigned by a supervisor
• Completes day-to-day Data Entry tasks without immediate supervision but has ready access to advice from more experienced team members
• Research incoming checks (primarily sent in by Providers, Finance and Network Operations)
• Responsible for documenting incoming check within our claims system as well as our DPL tracking module
• Maintain accurate records and files Responsible for scanning all checks and all supporting documentation into AppX viewing system, and then routing them to the appropriate Finance team to be deposited
• Support the outgoing check process (refund checks to providers) by researching and preparing supporting documentation to be sent with provider refund checks
• Interface with providers (responsible for making outbound calls to providers when additional information is needed to link a refund payment received to a provider/member claim
• May be responsible for the review, research, evaluation, and applying provider refund checks to overpaid professional and facility claims which may require reprocessing CMS 1500 as well as UBs
• Utilizes expertise to appropriately apply claim concepts, rules, and departmental practices, ensuring accuracy, and timeliness of provider refunds
• Possibly reprocesses paper claims and/or electronic claims. Determines whether to return, pend, deny, or apply provider refund to claims

Qualifications:

• High School diploma or GED
• 2+ yrs in a data entry or administrative role
• 1+ year of experience in the Healthcare Industry preferred
• Medical Terminology and Coding a plus
• Excellent customer centric and analytical skills
• Comfortable with working and navigating in multiple claim systems to include applicable CMS Websites
• Attention to detail
• Ability to navigate multiple system
• Exposure to claims processing systems and electronic filing/scanning applications (such as QNXT and APPX) a plus
• Demonstrated proficiency using PC software and high-level capacity to multitask independently
• Excellent written and oral communication skills
• Ability to perform in a high volume, fast paced claims environment
• Proficient with Microsoft office, specifically strong skills with Excel
• Must be reliable with strong attendance and work ethic
• Self-Directed yet able to work in a Team Environment

This position is onsite, working in our Nashville office, within normal business hours Monday - Friday, or as business needs dictate.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.About The Cigna GroupDoing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, were dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.

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