The Cigna Group

Business Project Lead Analyst

The Cigna Group

full-time

Posted on:

Location Type: Remote

Location: California • Connecticut • United States

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Salary

💰 $75,700 - $126,100 per year

Job Level

Senior

About the role

  • Submit, manage, and track TIN add and removal requests for prepayment edits to support appropriate claim intervention
  • Submit, monitor, and remove overpayment suppression requests based on defined case types and status changes
  • Create and submit flag requests for segments and Provider IDs (PIDs) associated with flagged TINs
  • Perform claims research and analysis to support protocol management, workflow validation, and issue resolution
  • Partner with the Protocol Manager (Fraud Manager) and Payment Accuracy teams to identify, troubleshoot, and resolve prepay edit and workflow issues
  • Research and coordinate provider update requests in accordance with established SIU processes
  • Support EFT setup and change requests, including outreach for approval/denial and submission of required documentation
  • Collaborate with internal partners to ensure timely execution of system updates and operational requests
  • Maintain ownership, accuracy, and documentation of assigned requests through completion
  • Support audit readiness by ensuring control execution, documentation, and request traceability within SIU workflows

Requirements

  • Bachelor’s degree strongly preferred, or equivalent relevant work experience
  • 3+ years of experience supporting prepay edits and claim processing
  • Demonstrated experience working in a highly matrixed environment
  • Strong analytical, research, and problem-solving skills
  • Ability to manage multiple priorities and respond with appropriate urgency
  • Proficiency in Microsoft Office (Excel, Word, PowerPoint)
  • Excellent written and verbal communication skills
  • Strong organizational and time-management skills
  • Familiarity with audit findings, claim quality issues, and control-based operations preferred
Benefits
  • medical, vision, dental, and 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
claims researchclaim processingprepay editsproblem-solvingworkflow validationaudit readinesscontrol executiondocumentationEFT setupcase management
Soft Skills
analytical skillsorganizational skillstime-management skillscommunication skillsability to manage multiple prioritiescollaborationtroubleshootingissue resolutionattention to detailadaptability