Senior Plan Implementation Analyst
The Cigna Group
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $55,200 - $92,000 per year
Job Level
About the role
- Perform contract reads and work on any fall-out issues from the contracts
- Understand and follow all loading instruction, policy and procedure documentation
- Continually identify and escalate process gaps and opportunities for process efficiencies across documentation to avoid negative customer impacts
- Loads in HCPM, Facets, Proclaim & PWB
- Work on our National Ancillary pended claim issues that come from the pended claim team
- Follow up with the manager on infractions
- Able to understand the interdependencies between business systems, teams and matrix partners; recognizes when changes or additional analysis needs to be conducted and provide appropriate feedback and suggestions
- Participate in peer training and coaching support to obtain required processing knowledge
- Participate in workload balancing daily as needs arise to support work streams and functions
- Understands needs of the team and supports the team
- Initiate accurate problem identification and present root cause analysis findings utilizing appropriate data trending tools and resources
- Collaborate to implement corrective actions
- Meet deadlines and accept additional tasks and assignments while maintaining established quality, production, and team timeliness standards
- Able to work successfully in a team environment
- Able to work and collaborate with matrix partners to provide regular data performance feedback, close data integrity gaps and proactively seek resolutions
Requirements
- Bachelor’s degree or higher strongly preferred or equivalent work experience required
- 2+ years of prior work experience with loading provider data required
- Understand how contracts are set up and how current business policies and technology will affect claim payment
- Working knowledge of HCPM, Facets, Proclaim and PWB/CPF required
- Proficiency with Microsoft Word and Access preferred
- Excel experience is required
- Prior claim exposure/experience highly preferred
- Proven ability to maintain positive working relationships, receiving and providing feedback, coaching and guidance to/from other staff members is required
- Self-starter with proven technical, analytical, negotiating, problem-solving, organizational and time management skills
- Self-motivated, detail oriented, decisive, and adaptable to change
- Ability to function well in a fast-paced, demanding environment
- Must be able to effectively communicate across a wide variety of topics to various audiences
- Ability to work independently while managing multiple tasks and meeting deadlines while also being a strong team player, partnering with others to collaboratively resolve issues and deliver solutions
Benefits
- medical, vision, dental benefits
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
loading provider dataroot cause analysisdata trendingExcelMicrosoft WordMicrosoft AccessHCPMFacetsProclaimPWB
Soft Skills
problem-solvingorganizational skillstime managementcommunicationteam collaborationfeedbackcoachingadaptabilityself-motivationrelationship management
Certifications
Bachelor’s degree