This is a hybrid role with on-site presence required POSITION SUMMARY The Enrollment/Billing Senior Advisor works strategically with Accredo Revenue Cycle Management (RCM) Collections partners to identify risk and opportunity for a payor that has decreased cash flow, accounts receivable collections challenges, and increased aging that is impacting Accredo's financial performance. Through this review, the Senior Advisor role will be responsible for engaging a variety of Cigna matrix partners (e.g Account Management Team, Contracting, Underwriting, Accredo Collections, Vendor Management, Clearance, Legal/Compliance, Finance, Accounting) and the appropriate payor points of contact to resolve the issues preventing timely and accurate claim payment. The Senior Advisor will lead/facilitate internal and external-facing meetings, lead multi-functional projects, perform financial and operational analyses, report out findings to key stakeholders, deliver on process improvements, make financial reserve recommendations to Accounting, and resolve operations issues within Accredo and with payors. During discussions with a payor, if the reason identified for collections challenges is directly linked to Accredo process, it is the responsibility of the Senior Advisor to collaborate internally and drive solutions that will reduce payer-denied claims and mitigate bad debt.
ESSENTIAL FUNCTIONS Financial focus on decreasing and mitigating bad debt and managing payer accounts receivable.
Excellent verbal and written communication and presentation skills.
Detail oriented with strong organization skills.
Ability to collaborate across multiple stakeholders and work streams to resolve root causes issues impacting receivables.
Strong project management skills to achieve cross-functional results.
Build and develop client-facing relationships that are key to identifying and resolving complex issues that are impacting collections and/or contributing to bad debt.
Understanding/identifying internal operational processes that may lead to bad debt, identify appropriate opportunity for improvement and increase profitability at both the drug and payor level.
Identification of Accounts Receivables at risk of non-payment, and basic understanding of financial payor reserves and bad debt impacts (ie. improper authorizations, incorrect benefit billed, incorrect payor).
Preparation, review, and presentation of bi-weekly and monthly payor risk analysis with internal partners, including Account Management, RCM, Finance and Accounting.
Basic understanding of contracts and ability to make recommendations to improve cash flow.
Support reporting needs associated with accounts receivables for quarterly business reviews with the payor and account team.
Coordinate settlements between Accredo and payors as needed which includes owning the spreadsheets with the payors, owning communications of reserve, working with the Account Management team on legal considerations, coordinating the posting of the payment, and submitting the adjustments for Boston Workstation (RPA) processing.
Working knowledge of MS products (excel/PowerPoint, Word, Visio & OneNote) and Tableau. Alteryx knowledge preferred.
Willingness to travel 10-20%
QUALIFICATIONS 4+ years relevant work experience or BA/BS degree.
Financial Acumen.
End to end/cross-functional process improvement orientation.
Ability to extract, analyze, synthesize and report on large quantities of data.
Comfortable with data modeling and reporting tools.
Adept at working in a fast-paced work environment and is adaptable to the changing needs of the business.
Advanced problem-solving and analytical skills.
Ability to make informed decisions independently with imperfect information.
Ability to manage multiple priorities, drive results, execute and deliver timely.
Knowledge of pharmacy operations, processes and business model strongly preferred.
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 Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. 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. 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: for support. Do not email 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.
