Audit Specialist - Evernorth - Remote

Join a team that plays a critical role in ensuring accuracy, compliance, and operational excellence. The Audit Specialist is responsible for completing payer audits and supporting quality initiatives that help drive business success. The ideal candidate will have knowledge of home infusion and state and federal guidelines, along with strong communication, problem-solving, and organizational skills. This role offers the opportunity to work independently, collaborate across departments, and make a meaningful impact through attention to detail and process improvement. Proficiency in Microsoft 365 is required.

What you'll do to make a difference:

• Effectively prioritize and complete all assigned tasks

• Review and distribute provider correspondence to appropriate departments

• Complete payer audits and appeals in a timely manner and before deadlines

• Perform quarterly quality audit checks

• Perform in accordance with system-wide competencies/behaviors

What you need to be successful:

• High School diploma or GED required

• Proficiency in the Microsoft Office Suite

• 2+ years of experience in home infusion revenue cycle required

• Strong knowledge of Federal and State billing guidelines

• Working knowledge of basic medical terminology

• Excellent verbal and written communication skills

• Strong customer service orientation

• Strong interpersonal and organizational skills, with the ability to work on multiple tasks simultaneously

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 27 - 40 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.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

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 need a reasonable accommodation to complete the online application process, please email [email protected] 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.