Job Description

As an Enrollment/Billing Senior Representative you would be responsible for reviewing, validating, updating and completing records for Medicare Advantage membership in accordance to Medicare guidelines.Job Duties:

• Review file data monthly and daily CMS files to ensure appropriate data is collected to support system results
• Perform processes in accordance with CMS guidelines
• Submit/update data in ECRS
• Ensure that Facets and EAM have the most accurate data for claims payment purposes
• Make outreach calls to members to validate missing or received information
• Provide assistance to staff as needed as well as keeping management knowledgeable of any issues that need additional guidance
• Implement and maintain up to date process flows for the processes for the Medicare Advantage product line
• Customer service and satisfaction is mission of incumbent

Requirements Include:

• High School Diploma or GED
• 2+ years Healthcare experience required, Medicare related role preferred
• Strong PC, computer systems, data entry, data base and word processing knowledge as well as refined communication skills for identifying and resolving customer problems
• Position requires professional level written and verbal communication skills
• Organizational ability for coordination of customer service activity and analytical skills to resolve administrative questions
• Strong customer satisfaction focus
• Strong ability to work in matrix environment
• Knowledge of CIGNA\'s Medicare Advantage products, CMS regulations is helpful
• Ability to identify appropriate matrix partners/areas that need to be involved in member resolutions
• Understanding of audit requirements both internal and external
• Ability to analyze, reconcile and report data across all required job functions
• Working knowledge of health and pharmacy insurance, administrative processes as well as CMS regulations and procedures to effectively service members
• Position requires problem resolution, strong communication, reporting and information systems interface skills
• With general managerial input, the incumbent establishes priorities for numerous scenarios

We expect this role to be remote, work from home, and have a working schedule Monday \xe2\x80\x93 Friday within 6:30am \xe2\x80\x93 6:00pm.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 18 - 28 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\xe2\x80\x99s why you\xe2\x80\x99ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you\xe2\x80\x99ll 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 .About Cigna HealthcareCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

The Cigna Group