Plan Implementation Sr. Representative - Evernorth - Remote

The Cigna Group

Remote
Base: 25 - 37 usd / hourly; bonus/equity: eligible...
Provider demographic and reimbursement data management
Client specific network (csn) contract interpretation
Root cause analysis for claim issues
Responsible for the management of provider demographic and reimbursement data for Client Specific Networks and timely reporting back to the client contact

Job Summary

  • Responsible for the management of provider demographic and reimbursement data for Client Specific Networks and timely reporting back to the client contact.
  • Reviews, researches, and investigates root cause for claim and fallout issues using various systems and performs root cause analysis and individual outreach resolution.
  • 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.

Matching Summary

Responsible for the management of provider demographic and reimbursement data for Client Specific Networks and timely reporting back to the client contact.

Salary

Base: 25 - 37 USD / hourly; Bonus/Equity: Eligible for annual bonus plan; Benefits: Comprehensive benefits including medical, vision, dental, 401(k), PTO

Skills & Requirements

Must-have

  • Provider demographic and reimbursement data management
  • Client Specific Network (CSN) contract interpretation
  • Root cause analysis for claim issues
  • Provider data loading in Cigna systems
  • MS Office proficiency (Access, Excel)

Nice-to-have

  • Subject Matter Expert for process improvement
  • Automation opportunities identification
  • Customer Focus
  • Critical-thinking
  • Priority Setting

Key Requirements

  • High School Diploma or GED
  • Experience with Proclaim or HCPM or CPF
  • Experience with root-cause analysis
  • Ability to work independently managing multiple tasks
  • Proven skills in data management accuracy

Work Rights

Not specified

Tailored Resume

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