Cigna Healthcare is looking for a skilled and detail-oriented Medical Billing & Coding Specialist to join our team in a remote capacity. As a key member of the Cigna healthcare team, you will play an essential role in ensuring accurate and timely coding, billing, and claims processing for our members. This remote position offers the flexibility to work from home, providing you with a great opportunity to contribute to the efficiency of our healthcare services while enjoying a healthy work-life balance.

If you are an experienced Medical Billing & Coding Specialist with a strong understanding of medical codes, insurance processes, and healthcare regulations, we want to hear from you!

Key Responsibilities:

• Medical Coding: Accurately assign ICD-10, CPT, and HCPCS codes to patient diagnoses, procedures, and services in compliance with healthcare regulations and payer requirements.
• Billing & Claims Submission: Prepare and submit medical claims to insurance carriers, ensuring all required documentation and codes are accurate to minimize claim rejections and denials.
• Claims Resolution: Review and resolve denied or rejected claims by investigating discrepancies, appealing decisions, and working directly with insurance companies, healthcare providers, and members.
• Patient Billing: Generate patient statements, ensuring that patients are accurately billed for services rendered. Address patient inquiries and provide clear explanations regarding charges and payment options.
• Insurance Verification: Verify insurance eligibility and coverage details for patients, ensuring that services provided are covered under their insurance plans.
• Documentation & Compliance: Maintain accurate and complete patient records, adhering to HIPAA regulations and other industry standards to ensure confidentiality and security.
• Collaboration with Providers: Work closely with healthcare providers, medical staff, and insurance companies to resolve any billing-related issues, ensuring smooth communication and effective problem resolution.
• Stay Current with Coding Updates: Keep up to date with changes in coding guidelines, billing procedures, and insurance policies to ensure compliance with industry standards.

Required Qualifications:

• High school diploma or equivalent; Certification in Medical Billing & Coding (e.g., CPC, CCS, or similar) required.
• 2+ years of experience in medical billing and coding, preferably within a managed care environment.
• In-depth knowledge of ICD-10, CPT, HCPCS, and other medical coding systems.
• Strong understanding of insurance processes, billing procedures, and payer guidelines.
• Proficiency in medical billing software and electronic health record (EHR) systems.
• Detail-oriented with excellent analytical and problem-solving skills.
• Ability to work independently and manage a remote workload efficiently.
• Excellent communication skills, both written and verbal, to interact with patients, healthcare providers, and insurance companies.

Preferred Qualifications:

• Associate degree in healthcare or a related field.
• Experience working with Cigna or similar health insurance providers.
• Knowledge of regulatory requirements such as HIPAA, Medicare, and Medicaid billing.
• Familiarity with healthcare coding audits and reviews.

Why Cigna?

• Remote Work Flexibility: Enjoy the convenience of working from home, making this position ideal for those seeking work-life balance.
• Career Growth: Cigna offers a wealth of opportunities for professional development, including ongoing training and certification programs.
• Competitive Benefits: Access to a comprehensive benefits package, including healthcare, dental, vision, retirement plans, and wellness programs to support your personal and professional well-being.
• Inclusive Culture: Cigna values diversity and strives to create an inclusive workplace where all employees can thrive.

How to Apply:If you are a qualified Medical Billing & Coding Specialist passionate about improving healthcare processes and providing exceptional service, apply today to join Cigna Healthcare innovative remote team!