The Cigna Group

Operations

• Supervise daily intake operations by assigning tasks, supporting staff, monitoring outcomes, and reporting key updates to leadership.
• Maintain expertise across functional areas, including onboarding, insurance verification, authorization, patient advocacy, and support services.
• Develop work schedules, implement departmental guidelines, conduct staff meetings, and communicate updates related to processes and contracts.
• Lead recruitment, hiring, onboarding, training, and competency development to maintain a skilled and engaged workforce.
• Monitor team performance, provide coaching, conduct evaluations, and recommend corrective action when needed.
• Ensure productivity goals, regulatory requirements, and accreditation standards are consistently met.
• Serve as a resource for intake personnel, addressing questions and supporting problem resolution.
• Model organizational competencies and behaviors in all interactions and leadership activities.

Supervisor, Intake Operations

Collections

• Manage third-party billing and collections, ensuring timely and accurate processing of claims and appeals.
• Investigate denials and rejections to identify root causes and recommend actions that prevent repeat issues.
• Review claim processing to confirm proper payment and pursue corrective steps when discrepancies arise.
• Process payer appeal requests within required timeframes and track outcomes.
• Contact payers or patients, as appropriate, to resolve outstanding issues.
• Document all collections activity in patient notes and accounts receivable reports.
• Evaluate payer guidelines to determine whether claims should be corrected, refiled, or appealed.
• Interpret EOBs to validate payment accuracy and guide next steps.
• Identify and correct claim errors to support full reimbursement.
• Support continuous improvement by identifying workflow enhancements that strengthen financial performance.

Collections Specialist

Insurance

• Verify insurance coverage, calculate costs, and document details accurately in patient profiles
• Enter and update patient demographics and maintain complete, organized records
• Determine medical vs. pharmacy benefits and generate financial responsibility letters
• Review benefits with patients and identify copay, foundation, or donated drug assistance programs
• Secure required insurance documents and obtain prior authorizations when needed
• Coordinate completion of financial assistance forms, payment agreements, and waivers
• Assist with training new employees and support daily workflow organization
• Create hospital and physician codes when necessary and support reimbursement research
• Collaborate with team members to prioritize tasks and maintain a customer-focused service mindset
• Meet quality and productivity standards, demonstrating reliability and strong follow‑through
• Perform additional duties as assigned to support operational needs

Insurance Verification Coordinator II

Vice President

• Lead clinical transformation strategies that advance care delivery and improve patient outcomes.
• Identify and implement innovative practices that strengthen clinical quality, safety, and operational effectiveness.
• Oversee quality improvement programs, including metric development, data analysis, benchmarking, and performance reporting.
• Drive continuous improvement through evidence-based practices and cross-functional collaboration.
• Ensure adherence to accreditation standards and regulatory requirements across all clinical operations.
• Partner with legal, compliance, and risk teams to proactively address regulatory needs and support clinical integrity.
• Provide strategic guidance to clinical leaders and interdisciplinary teams.
• Foster a culture of accountability, collaboration, learning, and professional development.
• Support growth and marketing teams by aligning clinical strategies with brand objectives and market initiatives.
• Offer clinical insight for marketing content, service line development, and external engagements.
• Represent the organization in industry forums, regulatory discussions, and community leadership initiatives.
• Evaluate, recommend, and support emerging technologies that improve clinical workflows and digital health integration.
• Review and enhance best practices in home infusion and specialty pharmacy to strengthen compliance and operational efficiency.
• Contribute to policy and procedure development and ongoing refinement.
• Provide problem resolution and ongoing oversight that supports partner relations and experience.
• Guide system selection, configuration, and optimization for pharmacy information systems.
• Lead process improvement initiatives that elevate service quality and operational excellence.
• Educate and mentor PharmD students, PGY1 residents, and clinical staff as needed.

Supervisor, Intake Operations

Collections Specialist

Insurance Verification Coordinator II

Vice President, Clinical Transformation – Quality