POSITION SUMMARY:
This position is responsible for account receivable activity for a specific Provider Book of Business tied to an account management team. They will be a key partner to the Provider Relations Executive supporting strategic planning to improve provider experience. Ensures timely and accurate claims administration, proactively monitors results, and leverages resources and tools to assist Health Care Providers in managing their accounts receivables. Provides direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs. Regularly meets with assigned Health Care Providers to discuss results, review issue trends, and develop action plans for improvement. Engages matrix partners to achieve service improvements and minimize contract interpretation issues. Communicates and educates internally regarding issues/trends to minimize errors and improve claim accuracy. They monitor contractual performance guarantees and late payment interest to minimize financial impacts.
Serves as a key member of the account management team responsible for Accounts Receivable Management
Collaborates with experience manager and matrix partners to identify, resolve and improve Accounts Receivable issues
Key contributor to the development of the provider strategic plan for an aligned book of business
Proactively monitors account receivable, performance guarantees and other accounts receivable related issues and communicates results to the Provider Relations Executive
Drives root cause analysis, trending related to accounts receivable resolution
Interacts directly with provider to understand, educate, communicate and resolve accounts receivable issues
Participates in face to face meetings with the Provider Relations Executive as needed to act as an accounts receivable Subject Matter Expert
Manages accounts receivable issues/corrective action plans
Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause
Supports service experience review process for specific book of business as defined by the Service Experience Review strategy
Contributes to market intelligence, documenting and sharing
Achieves and or exceeds Service Level Agreements
Responsible for all pre/post contract set up review for assigned book of business
Responsible for tracking and trending all accounts receivable related issues timely and accurately in appropriate tools
Ability to read and understand data results
POSITION REQUIREMENTS
Bachelor's degree or higher strongly preferred or equivalent work experience required
3+ years of experience in benefits and claims administration and/or relationship or project management experience
Advanced working knowledge of Proclaim and Facets required (PMHS helpful)
Proficient in Excel and PowerPoint
Access knowledge helpful
Experience with provider contracting or loading
Demonstrated ability to successfully interact with both internal and external customers at all levels
Demonstrated ability to perform root cause analysis on claims issues required
Demonstrated ability to manage and resolve problems to satisfactory completion
Project management skills to include time management, task analysis and breakdown and resource utilization
Strong facilitation and negotiation skills - 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
Ability to travel up to 20% required.
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 65,500 - 109,100 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.
