Accounts Receivable Analyst

Summary:

As a member of the Provider Solutions and Operations team, the Accounts Receivable Analyst / Provider Relations Analyst role supports the Service Model through claim problem analysis, root cause identification, and resolution.  This is an internally facing role supporting the Accounts Receivable Management team and the dedicated Gold-tier and Silver-tier participating providers.

Duties and Responsibilities:

• Collaborates with matrix partners to identify, resolve and improve Accounts Receivable issues by utilizing claim knowledge, research and critical thinking skills
• Routinely engages, consults and influences matrix partners to achieve service improvements and minimize contract interpretation
• Drives root cause analysis trending related to accounts receivable resolution
• Leads efforts to research system issues and identify appropriate solutions for the business operations
• Manages escalated issues received through appropriate workflow tools
• Communicates recommendations for changes to improve service as identified through root cause analysis
• Communicates and educates internally regarding issues/trends to minimize errors and improve claim accuracy 
• Understands how contract set up and current business policies and technology will affect claim payment
• Participates in meetings as needed to act as a Claim Subject Matter Expert
• Provides education on AR processes to internal partners
• May participate in or lead special project initiatives
• Achieves and or exceeds Service Level Agreements

Qualifications:

• Associate's Degree or higher strongly preferred or equivalent work experience required.
• 3+ years of experience in claims administration highly preferred.
• 3+ years of experience in claims processing required.
• Advanced knowledge of Proclaim and Facets required.
• Advanced knowledge of other Cigna claim processing systems preferred.
• Skills critical to this role include an intricate knowledge of current claim business practices, policies and procedures, the ability to link that knowledge to the multiple aspects of technology and the output of claim payment with the ability to navigate across business units to identify root cause
• Solid proficiency in Excel (basic formulas, V lookups, filtering and formatting are all required).
• Skills to include time management, task analysis and breakdown and resource utilization
• Understanding of the affect that the end result has on Provider satisfaction
• Demonstrated ability to successfully interact with both internal and external customers at all levels
• Demonstrated ability to take ownership of tasks/projects and perform work under minimal supervision with exceptional outcomes
• Demonstrated ability to see the "big picture" and understand how each phase of the claims payment process affects the end result and provider satisfaction

CORE COMPETENCIES

Plans and Aligns, Collaborates, Instill Trust, Communicates Effectively,

Self-Development, Situational Adaptability, Being Resilient, Action Oriented,

Optimize Work Processes, Customer Focus

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, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About The Cigna Group

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 seeyourself@thecignagroup.com 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.