As a member of the Provider Solutions and Operations team, this role Serves as a key member of the Provider Solutions Circle of Excellence (PSCOE) responsible for providers’ Accounts Receivable Management activity for Non-Dedicated Providers for commercial lines of business. This is an externally facing role.

Responsibilities:

• Ensures timely and accurate claims administration, monitors results, and leverages resources and tools to assist providers in managing their accounts receivables

• Responsible for tracking and trending all accounts receivable related issues timely and accurately in appropriate tools

• Ensure provider satisfaction for all claim project results

• Collaborates with local market matrix partners to identify, resolve and improve Accounts Receivable issues

• Contributes to provider strategic action plans for assigned markets; as requested

• Drives root cause analysis and trending related to Accounts Receivable resolution

• Serves as Subject Matter Expert internally and externally on claim processing and reimbursement policies

• Communicates and educates regarding issues/trends to minimize errors and improve claim accuracy

• Interacts directly with provider to understand, educate, communicate and resolve accounts receivable issues

• Participates in provider meetings with local team to act as an Accounts Receivable Subject Matter Expert as requested

• Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause

• Engages matrix partners to achieve service improvements and minimize contract interpretation issues

• Provides direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs.

• Participates in cross functional project initiatives and workgroups, as requested

• Achieves and/or exceeds Service Level Agreements

Qualifications:

• Bachelor's degree or higher strongly preferred or equivalent work experience required

• Advanced experience using Proclaim is required

• Knowledge of other claim and supporting systems is preferred

• Solid Excel experience using the VLOOKUP function is required

• Experience with Cigna claim processing, claim appeals, or claim quality preferred

• Demonstrated ability to successfully interact with both internal and external customers at all levels

• Demonstrated ability to perform root cause analysis on claims issues

• Demonstrated ability to manage and resolve problems to satisfactory completion

• Skills to include time management, task analysis and breakdown and resource utilization

• Demonstrated ability to present detailed technical information to a less knowledgeable audience and negotiate resolutions in a mutually beneficial manner to both Cigna and the provider

• Demonstrated ability to see the "big picture" - understand how each phase of the claims payment process affects the end result and provider satisfaction

• Demonstrated ability to handle confrontational situations in a professional manner ending in a better partnership between Cigna and the provider

• Demonstrated ability to take ownership of tasks/projects and perform work under minimal supervision with exceptional outcomes

• Demonstrated ability to read and understand data results

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 annual salary of 58,100 - 96,900 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.