About The Position

Provider Relations Lead Analyst - Payroll Title Serves as a key member of the account management team responsible for AR Management Collaborate with experience manager and matrix partners to identify, resolve and improve AR issues 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 action plans Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause analysis Supports service intent review process for specific BOB as defined by the SIR strategy Contributes to market intelligence, documenting and sharing Achieves and 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 QUALIFICATIONS Bachelor’s degree or higher strongly preferred or equivalent work experience required 5+ years’ experience in benefits and claims administration and/or relationship or project management experience Advanced knowledge of Cigna claims and supporting systems to include Proclaim (required), Facets (highly preferred) and PMHS (preferred) Excel required – to include pivot tables and VLOOKUP experience preferred 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. Demonstrated ability to manage and resolve problems to satisfactory completion 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 66,600 - 111,000 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. 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 and paid holidays. For more details on our employee benefits programs, click here. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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. 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.

Requirements

  • Bachelor’s degree or higher strongly preferred or equivalent work experience required
  • 5+ years’ experience in benefits and claims administration and/or relationship or project management experience
  • Advanced knowledge of Cigna claims and supporting systems to include Proclaim (required), Facets (highly preferred) and PMHS (preferred)
  • Excel required – to include pivot tables and VLOOKUP experience 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
  • 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.

Nice To Haves

  • Access knowledge helpful
  • Experience with provider contracting or loading

Responsibilities

  • Serves as a key member of the account management team responsible for AR Management
  • Collaborate with experience manager and matrix partners to identify, resolve and improve AR issues
  • 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 action plans
  • Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause analysis
  • Supports service intent review process for specific BOB as defined by the SIR strategy
  • Contributes to market intelligence, documenting and sharing
  • Achieves and 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

Benefits

  • medical
  • vision
  • dental
  • well-being and behavioral health programs
  • 401(k)
  • company paid life insurance
  • tuition reimbursement
  • a minimum of 18 days of paid time off per year
  • paid holidays
  • annual bonus plan

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Number of Employees

5,001-10,000 employees

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