• Provide Epic product function, design, and build expertise and experience needed for successful product implementation. • Serve as the primary resource dedicated to application design, validation, and build within assigned area. • Assesses current state, designs and implements future-state workflows by interacting with department representatives to analyze business/operational needs, and translates these into proper system configuration. • Provide demonstration of system functionality creates and submits regular status reports to immediate Lead Analyst/Project Manager/IT Leadership as assigned. • Coordinate/facilitate organizational meetings and attends weekly team meetings to discuss team and project related activities, issues, changes, communications, and updates. • Develop, support, and maintain documentation and procedures as needed and provides training to other IT staff and user clients as appropriate. • Troubleshoot problems identified by team members and end-users, analyzes and coordinates system changes, and implements approved changes based on customer-designated priorities. • Review and test build and new releases/enhancements prior to implementing in the production environment, and maintain established guidelines related to build standards (logs/tracks issues, naming and numbering conventions, build trackers etc.) and Change Control processes. • Collaborate with Principal Trainers in the design and development of role-based training programs to support the workflows to be implemented, and assists with training of end-users on proper use of the system. • Contribute to preparation of testing scripts, performs unit/system/integrated testing tasks in a structured manner, and appropriately documents test results. • Provide expertise and experience to the development of activation plans, application activation tasks, and production environment readiness. • Provide on-site support as needed during Go-live/Downtime events.

Role Description Are you energized by helping patients understand their healthcare journey and feel confident about next steps? As an Enrollment/Billing Associate Representative, you play a vital role in creating a clear, compassionate, and seamless experience for patients receiving specialty pharmacy and infusion services. As part of Evernorth Health Services, this role supports CarePathRx, a leader in specialty pharmacy and infusion services working alongside hospitals and health systems. Our team is ambitious, patient-focused, and deeply committed to delivering care with empathy and expertise. Schedule: Monday–Friday, 9 AM–5:30 PM EST What you’ll do to make a difference: - Deliver a positive patient experience by clearly explaining financial responsibility, insurance benefits, and next steps with empathy and professionalism. - Proactively contact patients to review coverage details and securely obtain payment information when applicable. - Create accurate and timely patient financial responsibility letters based on documented insurance benefits. - Review patient accounts to identify enrollment needs and initiate appropriate outreach. - Enter and update patient demographic and referral information to support timely care delivery. - Communicate patient updates effectively to internal partners to ensure alignment and continuity. - Prioritize work thoughtfully to meet service expectations while maintaining high accuracy and quality. Qualifications - High school diploma or GED. - 1+ years of customer service experience, preferably in a healthcare, billing, insurance, or patient-facing environment. - Strong verbal and written communication skills with the ability to explain information clearly and compassionately. - Proficiency with computers and Microsoft Office applications. - Ability to organize tasks, manage time effectively, and adapt in a fast-paced environment. - Experience with insurance verification, billing, or enrollment processes preferred. - Familiarity with medical terminology preferred. - Previous experience supporting specialty pharmacy, infusion services, or healthcare operations preferred. Requirements - 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. - For this position, we anticipate offering an hourly rate of 17.75 - 24 USD / hourly, depending on relevant factors, including experience and geographic location. - This role is also anticipated to be eligible to participate in an annual bonus plan. Benefits - Comprehensive range of benefits with a focus on supporting your whole health. - Health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of employment. - 401(k) plan. - Company paid life insurance. - Tuition reimbursement. - A minimum of 18 days of paid time off per year. - Paid holidays and leaves of absence. Company Description 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.

Role Description This position requires thorough knowledge of the Uniformed Bill, timely filing limits set forth by various payers, and various payer websites for follow up. Performs all duties related to timely and efficient billing and follow-up. Thorough understanding of commercial payer eligibility, benefits, determining primary payer, and covered benefits. Understanding of billing policies for auto and worker’s compensation as well as incarcerated patient payers. - Monitor commercial and specialty payer accounts receivable inventory to ensure timely follow up and claims resolution. - Adhere to quality and productivity standards assigned by management. - Submit account for appeal on accounts where retroactive coverage has been obtained. - Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership. - Follow up on unpaid commercial and third-party payer claims in a timely manner. - High dollar accounts will have consistent follow up until the account has been resolved. - Responsible for reviewing and understanding explanation of benefits/remittance advice. - Ensure statements are generated for the patient responsibility amounts. - Utilize insurance websites to view and resolve claims. - Perform extensive account follow-up and provide analysis of problem accounts. - Document all follow up efforts in a clear and concise manner into the AR system. - Compliance with State and Federal Regulations. - Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account. - Ensure medical record requests are documented and submitted in a timely manner. - Collaborate with denials team on difficult or reoccurring denials. - Complete tasks by deadline. - Identify and report all trends that may provide insight into payment challenges. - Phone contact with patient, physician office, attorney, etc for additional information to process the claim. - Attend seminars as requested. - Other duties as assigned. Qualifications - High School Diploma, or GED - 1 year of patient registration, billing or equivalent experience - Working knowledge of medical and insurance terms is desirable. - Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies. - Knowledge of general insurance requirements. - Experience working directly with EOBs and contractual adjustments. - General computer knowledge, working with electronic filing. - Ability to communicate verbally/in writing with professionalism. - Ability to meet productivity expectations.

Role Description The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics and/or inpatient OB/newborn encounters. This role is also responsible for charge review on clinic and hospital visits to ensure accurate professional charging and billing. - Requires the coder to be highly proficient in the proper assignment of ICD-10 CM, PCS, CPT, HCPCS, HCC, HEDIS CAT II, E/M and modifier codes. - Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland’s policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered. Qualifications - High school diploma required. - Must have successfully completed an approved coding program. - OR Must be a graduate of a health Information Management program. - Must have strong knowledge of Anatomy and Physiology and possess strong application skills. Requirements - Must have two (2) years of coding experience in an acute care setting or diverse clinical specialties. - Physician office coding, charging, and billing experience preferred. - May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above. - Must be certified through the American Health Information Management Association (AHIMA) as one of the following: - Registered Health Information Management Technician (RHIT) - Registered Health Information Management Administrator (RHIA) - Certified Coding Specialist (CCS) - Certified Coding Specialist – Physician Based (CCS-P) - Certified Coding Associate (CCA) certification - OR Must be certified through the American Association of Procedural Coders (AAPC) as one of the following: - Certified Professional Coder (CPC) - Certified Professional Coder-Hospital (CPC-H) - Certified Outpatient Coder (COC) - Score a minimum of 80% on a pre-employment inpatient/outpatient coding test. Contract coders with a proven coding accuracy rate of 95% at Parkland Health and Hospital System are exempt from this requirement. Skills or Special Abilities - Advance coding and charge review skills understanding the utilization of modifiers and other coding, charging and billing rules to include AMA and other state and federal organizations. - Advanced knowledge of ICD-9/ICD-10-CM/PCS, CPT-4/HCPCS, HCC and HEDIS CAT II, E/M coding and abstracting, APC classification and reimbursement structures, applicable coding edits and general knowledge of Local Coverage for hospital and professional billing. - Must have knowledge of medical terminology, the human disease process, anatomy and physiology. - Demonstrate proficiency in coding and encoder skills. - Demonstrate knowledge of computer software applications including MS Office and Computer Assisted Coding (CAC). - Knowledge of Epic EHR and 3M 360 coding and abstracting software is preferred. Responsibilities - Code, abstract and conduct charge quality review on all episodes of care on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS) and/or inpatient OB/newborn hospital and specialty clinic encounters according to coding conventions, guidelines and hospital policy. - Assigns appropriate diagnosis and procedures codes utilizing ICD 10-CM/PCS, CPT, HCPCS, HCC and HEDIS CAT II, E/M codes according to the Centers for Medicare & Medicaid Services (CMS) requirements for both professional and hospital billing. - May assist in training and reviewing the work of other coders for accuracy and efficiency. - Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards. - May verify, edit and/or enter charges based on documentation or payer/billing requirements reporting any discrepancies in a timely manner. - Updates, as appropriate, patient database with classification codes and resolves conflicts or inconsistencies to provide sufficient patient health information according to Parkland’s standards. - Stays abreast of the latest developments, advancements, and trends in the field of health information management by attending workshops, reading professional journals, actively participating in professional organizations, and integrates knowledge gained into current work practices. - Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland. - Facilitate a positive working relationship with physicians, nurses, and medical staff and hospital employees to ensure that all work related encounters are productive. - Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the Coding area. - Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. - Maintains CE hours and renew annual coding credentials.