Business Project Lead Analyst – Payment Integrity
The Cigna Group
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $75,700 - $126,100 per year
Job Level
About the role
- Lead strategic collaboration between recovery vendors, providers, and internal network partners
- Drive monthly provider and vendor discussions to review overpayment inventory
- Partner with Network and Contracting teams to address uncooperative providers
- Monitor vendor performance and accuracy, translating findings into corrective action plans
- Serve as a subject matter expert on claim identification and recovery processes
- Support client-driven and third-party audit initiatives by reviewing, analyzing, and reporting on recovery accuracy
- Evaluate provider contract audit language and recommend enhancements
- Analyze trends, exclusions, and provider behaviors to quantify financial impact
- Develop and deliver clear, actionable reporting for leadership, providers, vendors, and external stakeholders
- Enable vendor success through education on systems, procedures, and evolving recovery requirements
Requirements
- High School Diploma or G.E.D. required
- 3+ years of experience in payment integrity, provider relations, claims operations, or related healthcare analytics roles
- 2+ years of hands-on experience with healthcare claim systems such as PROCLAIM and FACETS
- Working knowledge of healthcare claim processing and recovery workflows
- Experience partnering across matrixed teams including Network, Legal, Contracting, Sales, and Operations
- Strong analytical and organizational skills
- Demonstrated ability to manage complex issues with appropriate urgency and sound judgment
- Proficiency in Microsoft Word and Excel
Benefits
- Medical, vision, and dental health insurance
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- 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
payment integrityclaims operationshealthcare analyticshealthcare claim systemsPROCLAIMFACETShealthcare claim processingrecovery workflowsanalytical skillsorganizational skills
Soft Skills
strategic collaborationcommunicationproblem-solvingjudgmenteducationleadershipvendor managementstakeholder engagementreportingtrend analysis
Certifications
High School DiplomaG.E.D.