Job Details

Business Project Sr. Analyst

The Business Project Sr. Analyst position is within Payment Integrity (Medicare and Commercial Coordination of Benefits Operations and Enhancements). The Sr. Analyst will be a key contributor and will report to the Operations Manager.

Responsibilities

Utilizes Medicare and Commercial Health Insurance expertise in conjunction with strong analytical and collaboration skills to partner with matrix partners and vendors ensuring accurate and timely benefit primacy determination in complex scenarios.

Communicates effectively with Cigna's vendor partners to assist them in maximizing post payment recovery efforts.

Responds timely to complex SharePoint inquiries (Intake application).

Analyzes weekly/monthly vendor management reporting for accuracy and assists with Cigna's determination as primary or secondary payer in complex situations.

Partners effectively with claim, call and client technical coaches to address primacy determination quality trends and efficiency improvement opportunities. Responds to requests for access to COB Smart portal and troubleshoots access issues within portal.

Participates in projects to support business initiatives.

Qualifications

Bachelor's degree or higher strongly preferred work experience required.

2+ years of work experience with Medicare and coordination of benefits primacy rules.

2+ years claim system and claim processing knowledge (Proclaim and Facets) preferred.

2+ years experience using Cigna applications (iview, CED, Oneview, etc.). Ability to work collaboratively within team as well as with matrix partners and outside vendors.

Ability to recognize and respond to issues with the appropriate sense of urgency, escalating problems as appropriate.

Strong time management skills.

Strong business acumen with the ability to multitask in a fast-paced environment.

Strong proficiency in Microsoft Office products, including Microsoft Excel, with the ability to create and generate spreadsheets.

Strong analytical skills with the ability to analyze data, identify potential problems or opportunities, and recommend and implement solutions.

Excellent verbal and written communication skills, including the ability to explain complex or technical topics clearly, communicate effectively with individuals and groups, and actively listen.

Detail-oriented with strong organizational and relationship-building skills.

Experience coaching peers preferred.

Demonstrated ability to positively embrace and adapt to change.

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.

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 and paid holidays.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.