Senior Claims Systems Analyst

The Cigna Group

Claims System Senior Analyst ensuring accurate configurations in eviCore claims processing systems. Collaborating with teams and supporting production issues for healthcare clients.

Posted 5/12/2026full-timeRemote • Alabama, Alaska, Arizona, Florida, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Missouri, New York, Ohio, Pennsylvania, Texas, Utah, Vermont, Washington • 🇺🇸 United StatesSenior💰 $55,100 - $91,800 per yearWebsite

Tech Stack

Tools & technologies

SDLCSQL

About the role

Key responsibilities & impact

Resolve non-routine issues escalated from leadership, business, clients and junior team members and act as a subject matter expert (SME) to business and IT for eviCore claims product setups/processes
Collaborate with internal and external clients to understand, and evaluate processes, procedures, job aids and identify solutions for procedural gaps
Analyze business and user requirements to design solutions and system configurations, specifications, create test plans/use cases perform SI testing, end to end testing and continuously improve adjudication automation and accuracy
Partner with technology and analytics teams to develop new data sources for reporting and act as liaison between business and technology to execute project initiatives, and resolve issues
Provide support with production issues as needed

Requirements

What you’ll need

High School Diploma or GED required, bachelor’s degree preferred
5+ years of healthcare claims lifecycle; configuration design, editing, claims system requirements, and analysis - REQUIRED
3+ years of experience in MS ACCESS - REQUIRED
3+ years of advanced experience with MS EXCEL - REQUIRED
3+ years of experience with SQL and SQL querying, REQUIRED
3+ years of experience with database management systems, creating test plans/use cases, and SDLC models, REQUIRED
3+ years of experience with MC400, McNet and RC3 systems, Preferred
3+ years of experience with claims adjudication, claims data types and editing rules (ICD, CPT/HCPC, NCCI, MPPR, OPPS, RBRVS, FFS), preferred

Benefits

Comp & perks

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
annual bonus plan

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

SQLMS AccessMS Exceldatabase management systemsclaims configuration designclaims system requirementstest plansuse casesSDLC modelsadjudication automation

Soft Skills

problem solvingcollaborationcommunicationanalytical thinkingsubject matter expertiseliaison skillssupportevaluationcontinuous improvementissue resolution

Certifications

High School DiplomaGEDBachelor's degree