Due to the Book of Business, we are looking to hire someone who is able to support the Mid-Atlantic region and East Coast hours.
This position is responsible for account receivable activity for a specific Provider Book of Business tied to an account management team. They will be a key partner to the Provider Relations Executive supporting strategic planning to improve provider experience. Ensures timely and accurate claims administration, proactively monitors results, and leverages resources and tools to assist Health Care Providers in managing their accounts receivables. Provides direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs. Regularly meets with assigned Health Care Providers to discuss results, review issue trends, and develop action plans for improvement. Engages matrix partners to achieve service improvements and minimize contract interpretation issues. Communicates and educates internally regarding issues/trends to minimize errors and improve claim accuracy. They monitor contractual performance guarantees and late payment interest to minimize financial impacts.
DUTIES AND RESPONSIBILITIES- Serves as a key member of the account management team responsible for Accounts Receivable Management
- Collaborates with Accounts Receivable Manager and matrix partners to identify, resolve and improve Accounts Receivable issues
- Key contributor to the development of the provider strategic plan for an aligned book of business
- Proactively monitors account receivable, performance guarantees and other accounts receivable related issues and communicates results to Accounts Receivable Manager
- Drives root cause analysis, trending related to accounts receivable resolution
- Interacts directly with provider to understand, educate, communicate and resolve accounts receivable issues
- Participates in face to face meetings with Accounts Receivable Manager as needed to act as an accounts receivable Subject Matter Expert
- Manages accounts receivable issues/corrective action plans
- Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause
- Supports service experience review process for specific book of business as defined by the Service Experience Review strategy
- Contributes to market intelligence, documenting and sharing
- Achieves and or exceeds Service Level Agreements
- Responsible for all pre/post contract set up review for assigned book of business
- Responsible for tracking and trending all accounts receivable related issues timely and accurately in appropriate tools
- Ability to read and understand data results
POSITION QUALIFICATIONS- Bachelor's Degree or higher strongly preferred or equivalent work experience
- 3+ years of experience in benefits and claims administration.
- 3+ years of relationship management and project management experience
- Advanced knowledge of Cigna claims and supporting systems (Proclaim, PMHS, Facets) highly preferred
- Proficient in Excel and Power Point
- Access knowledge helpful
- Experience with provider contracting or loading
- Demonstrated ability to successfully interact with both internal and external customers at all levels
- Demonstrated ability to perform root cause analysis on claims issues
- Demonstrated ability to manage and resolve problems to satisfactory completion
- Project management skills to include time management, task analysis and breakdown and resource utilization
- Strong facilitation and negotiation skills - demonstrated ability to present detailed technical information to a less knowledgeable audience and negotiate resolutions in a mutually beneficial manner to both Cigna and the provider
- Demonstrated ability to see the "big picture" - understand how each phase of the claims payment process affects the end result and provider satisfaction.
- Demonstrated ability to handle confrontational situations in a professional manner ending in a better partnership between Cigna and the provider
- Demonstrated ability to take ownership of tasks/projects and perform work under minimal supervision with exceptional outcomes
- Some travel required
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an annual salary of 66,600 - 111,000 USD / yearly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.
