Note: The job is a remote job and is open to candidates in USA. Evernorth Health Services is dedicated to improving the health and vitality of those they serve. The Financial Assistance Specialist will help patients access financial resources by coordinating assistance programs and resolving billing issues, ensuring accurate claims processing and maintaining compliant documentation.
Responsibilities
- Identify billing trends and proactively address issues to support timely reimbursement
- Review and correct claims, reprocess submissions, and interpret EOBs to understand denials
- Communicate with payers, patients, and external partners as needed
- Document all collections activity in patient records and maintain accurate notes in aging and reconciliation reports
- Process payer appeals within required timeframes and ensure billing accuracy
- Investigate claim discrepancies and review reimbursement contracts to support resolution
- Meet quality, productivity, and compliance standards as defined by leadership
- Process approved adjustments, home infusion/nursing claims, patient updates, and insurance changes
- Review unpaid claims, identify root causes, and determine next steps such as refiling or appeals
- Support copay and foundation program enrollment and maintain updated financial assistance documentation
- Maintain confidentiality and professionalism when handling patient financial information
- Perform additional duties as assigned to support revenue cycle operations
Skills
- High school diploma or GED
- One to three years of experience in medical billing, collections, or related healthcare financial roles
- Proficiency with Microsoft Office and ability to interpret billing codes and documentation
- Experience processing pharmacy claims
- Strong communication, customer service, and problem‑solving skills
- Ability to manage multiple tasks with strong attention to detail and accuracy
- Knowledge of copay and foundation assistance programs
- Understanding of insurance reimbursement, benefits, and payer guidelines
- Familiarity with ICD‑9, CPT‑4, HCPCS, and medical terminology
- Experience using systems such as HCN360 or CPR+
- Prior experience in home infusion billing or revenue cycle operations
Benefits
- Medical
- Vision
- Dental
- Well-being and behavioral health programs
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- A minimum of 18 days of paid time off per year
- Paid holidays
Company Overview
Flexible and connected pharmacy, care and benefit solutions that move organizations and people forward. It was founded in 2020, and is headquartered in St Louis, Missouri, USA, with a workforce of 10001+ employees. Its website is https://www.evernorth.com.Company H1B Sponsorship
Evernorth Health Services has a track record of offering H1B sponsorships, with 338 in 2025, 335 in 2024, 324 in 2023. Please note that this does not guarantee sponsorship for this specific role.
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