[Hiring] Senior Collections Specialist @The Cigna Group

Role Description

As a Senior Collections Specialist, you play a vital role in strengthening financial performance while improving the patient experience. You bring curiosity, persistence, and compassion to complex payer challenges—ensuring claims are resolved accurately, reimbursement is timely, and patients and partners are supported every step of the way. If you thrive in problem solving and want your work to make a meaningful impact, this role offers the opportunity to grow your expertise while contributing to high‑quality, patient‑centered care.

Hours: Monday- Friday, 8:30am-5pm EST

Responsibilities

• Drive timely and accurate reimbursement by actively managing pharmacy claim billing, collections, and follow‑up activities.
• Resolve denied, rejected, or underpaid claims by identifying root causes and applying corrective strategies that prevent repeat issues.
• Interpret explanations of benefits (EOBs) to validate reimbursement accuracy and determine next steps.
• Monitor accounts receivable and take ownership of outstanding balances through persistent payer or patient outreach.
• Prepare, submit, and track payer appeals within required timeframes, ensuring documentation supports favorable outcomes.
• Evaluate payer rules and reimbursement guidelines to determine whether claims should be corrected, refiled, or appealed.
• Ensure claim accuracy by identifying and correcting billing or submission errors that impact reimbursement.
• Maintain clear, timely 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.

Qualifications

• 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.

Requirements

• 2 or more years of experience in revenue cycle operations, pharmacy billing, or collections.
• Experience working with ICD‑10, CPT, HCPCS, and Medicare billing guidelines.
• Knowledge of pharmacy Part D claims, CE2000, home infusion billing, and third‑party payer rules.
• Experience using systems such as HCN360, CPR+, or comparable billing platforms.

Benefits

• Comprehensive range of health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) and company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays and leaves of absence.
• Hourly rate of 20 - 30 USD / hourly, depending on relevant factors, including experience and geographic location.
• Eligibility to participate in an annual bonus plan.

Company Description

At The Cigna Group, we’re 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.