Role Description The Claims Billing Specialist I reviews and processes billing inquiries and medical bills, ensuring accuracy and compliance with company policies, regulations, and HIPAA. The Specialist works with providers, vendors, and internal teams to resolve discrepancies, collect documentation, and assist with payment and penalty calculations. Under close supervision, the Specialist manages routine inquiries, escalates complex issues, and helps maintain efficient, accurate billing, payment, and claims operations. The position requires attention to detail, clear communication, and a commitment to professionalism, confidentiality, and ethical conduct. Essential Duties and Responsibilities - Conduct business at all times with the highest standards of personal, professional, and ethical conduct. - Research and process provider billing inquiries, identifying discrepancies and applying standard resolution steps. - Review, calculate, then process in-house payments. - Review medical bills and accurately complete claims management system work items and assigned tasks. - Communicate with providers and internal staff to gather required documentation. - Review and respond to incoming mail, emails, telephone calls, and fax transmissions. - Maintain accurate documentation in claims systems. - Ensure all billing activities comply with company policies, regulatory requirements, and applicable standards (including HIPAA). - Adhere to turnaround time parameters established by company policies and procedures. - Maintain confidentiality of all data and records in accordance with HIPAA and state regulations. - Participate in training to build knowledge of workers’ compensation billing and payment practices. - Perform special projects as assigned. - Other duties as assigned. Qualifications - 1 - 3 years of experience in workers comp claims or medical billing. - Demonstrated skill in working independently within role responsibility while demonstrating multitasking skills. - Excellent communication skills fostering a responsive customer service environment. - Excellent time management and organizational skills. - Ability to understand statutes, regulations and company policies and procedures. - Must be detail-oriented with demonstrated ability to handle multiple tasks simultaneously. - Ability to demonstrate initiative and to meet designated deadlines. - Proficiency in MS Office Suite (Word, Excel, Outlook) and other relevant software tools. - Proven ability to handle sensitive and confidential information with discretion and professionalism. - Equivalent combinations of education and experience may be considered. Requirements - Must have High School diploma or equivalent. - Some college preferred with experience and/or training in data management and paper media production. Working Conditions - Remote: This role is remote, and only open to candidates currently located in the United States and able to work without sponsorship. - It requires a suitable space that provides a private and quiet workplace. - Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed. - Travel: May be required to travel to off-site location(s) to attend meetings, as necessary. Hourly Pay Rate $22.00 per hour and a comprehensive benefits package, please follow the link to our benefits page for details! Benefits - Dynamic, fast-growing provider of workers' compensation insurance and services. - Positive, challenging work environment. - Opportunity to build your career while helping grow the business. - Core values: Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment. - Energetic environment that inspires top achievement.

Role Description Please note this role is open to Cigna Group retirees only. As a Home Infusion Registered Nurse with Accredo Specialty Pharmacy, part of Evernorth Health Services, you’ll bring your infusion nursing expertise to patients where they feel most comfortable—their homes. As an Infusion RN, you’ll deliver life-changing care while building meaningful relationships and driving positive health outcomes. - Provide safe and effective administration of specialty medications (including IV infusion) in patients’ homes. - Partner with pharmacists and care teams to ensure holistic patient well-being. - Document assessments, treatments, and progress to maintain accurate patient records. - Serve as the primary point of contact for patient updates and care coordination. - Demonstrate autonomy in clinical decision-making to achieve optimal outcomes. Qualifications - Active RN license in the state of practice. - Previous specialty pharmacy home infusion experience. - Proficiency in IV insertion and infusion techniques. - Valid driver’s license and ability to travel within a large geographic region. - Ability to do multiple patient visits per week, including some evenings and weekends as needed. Preferred Qualifications - Bachelor of Science in Nursing (BSN). - 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. Company Description Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes. 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.

• Assists the Coding Manager with the review of staff assignments for accuracy • Assists with day to day operations of Physician Coding Department to ensure productivity standards are met • Performs daily coding assignments • Assists with resolving coding questions, maintaining reports • Answers inquiries in a timely manner • Provide ongoing training to new and experienced physician based coders • Monitors the efficiency of coding review work queue activity • Assist with research in regards to coding questions and denials • Attends coding workshops and report information to coding staff • Assists with developing training guides and procedural manuals • Documents workflows and ensures staff follows workflows consistently

Overview Serves as the senior member of the corporate coding team by providing extensive knowledge for timely and accurate coding and DRG assignment. Performs the function of coding, DRG assignment, collection of predefined indicators, and abstracting medical records. Provides timely and accurate ICD-10-CM and ICD-10-PCS codes for reimbursement and specific information for statistical purposes. Serves as a liaison between coders and CDS team on coding and documentation issues. Reviews SMART accounts on a daily basis as assigned. **Eligible remote states include NC, FL, GA, SC, SD, TN, TX and VA.** Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Licensure Registered Health Information Technician Required - Or Registered Health Information Administrator Required - Or Certified Professional Coder Required - Or Certified Coding Specialist Required - Or Certified Outpatient Coder Required Education Associate's Degree Health Information Management Required Bachelor's Degree Health Information Management Preferred Experience 5 Years Coding - Inpatient Required Diagnosis-Related Group Analysis Required