POSITION SUMMARY:
This position is responsible for account receivable activity for a specific Health Care Professional (HCP) Book of Business (for the Mid-West/Mid-America Market) tied to an account management team. They will be a key partner to the experience manager 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 Professionals 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 Professionals 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 LPI to minimize financial impacts.
DUTIES AND RESPONSIBILITIES
Serves as a key member of the account management team responsible for AR Management
Collaborates with experience manager and matrix partners to identify, resolve and improve AR issue.
Key contributor to the development of the HCP strategic plan for an aligned BOB
Proactively monitors account receivable, performance guarantees and other AR related issues and communicates results to experience manager
Drives root cause analysis, trending related to AR resolution
Interacts directly with HCP to understand, educate, communicate and resolve AR issues
Participates in face to face meetings with EM as needed to act as an AR SME
Manages AR issue/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 BOB as defined by the SER 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 (BOB)
Responsible for tracking and trending all AR related issues timely and accurately in appropriate tools
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 knowledge of Proclaim required with Facets preferred.
Excel experience required (pivot tables/VLOOKUP nice to have)
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.
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.
Some minimal travel may be 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.
