[Hiring] Provider Claims Support Sr. Analyst - Express Scripts @Cigna Healthcare

Remote, USA Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Senior Analyst, Provider Claims Support is responsible for supporting both Network Providers and Internal Business Partners across all aspects of provider-submitted claims. This role assists with claim-related issues identified or reported internally and externally. • Delivers specific delegated tasks assigned by a supervisor within the Network Management job family. • Prepares, analyzes, reviews, and projects the financial impact of facility, ancillary, group, and/or behavioral health contracts. • Drafts contracts and conducts pre-contractual audits and surveys. • Demonstrates knowledge of contracting processes, contract management, network operations, Medicare fee schedules, financial terms, and performance metrics. • Completes day-to-day Network Operations tasks with minimal supervision. • Resolves non-routine issues escalated by more junior team members. • Supports the execution of operational activities within the Retail Network in alignment with ESI’s work plan and in compliance with requirements for Express Scripts clients and applicable regulatory agencies. • Supports the facilitation and execution of strategic network initiatives, requiring cross-functional coordination to lead, own, and manage relationships with Network Providers, internal Supply Chain business partners, and client account teams. Qualifications • Bachelor’s degree in a related field, or equivalent relevant work experience (preferred). • Knowledge of the healthcare and/or PBM industry. • Strong problem-solving and analytical skills. • Ability to work cross-functionally to research and resolve complex client and provider issues on a regular basis. • Ability to manage multiple escalated issues simultaneously under tight timelines. • Ability to adapt in a dynamic work environment, learn quickly, solve problems, and make decisions with minimal supervision. • Basic proficiency in Microsoft Office applications, including PowerPoint, email, and spreadsheet software. Requirements • 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. Benefits • Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting on day one of employment. • 401(k) with company match. • Company paid life insurance. • Tuition reimbursement. • A minimum of 18 days of paid time off per year and paid holidays. • Eligible to participate in an annual bonus plan. Apply tot his job
Apply Now

Similar Jobs

Medical Claim Analyst

Remote, USA Full-time

Medical Biller and Coder - Experienced

Remote, USA Full-time

Coding and Cost Analyst I - medical claims coding and claim edit review, Geising

Remote, USA Full-time

Remote Medical Biller

Remote, USA Full-time

Coding and Billing Specialist (US)

Remote, USA Full-time

Remote Medical Billing Specialist

Remote, USA Full-time

Remote Front Desk Coordinator / Billing Specialist

Remote, USA Full-time

Remote Medical Billing Appeals and Reviews No Surprise Billing Accounts Receivable Specialist

Remote, USA Full-time

Phone Claim Analyst - Supplemental Health

Remote, USA Full-time

Home Health Billing Analyst I

Remote, USA Full-time

**Experienced Remote Travel Agents and Customer Service Representatives – Deliver Exceptional Travel Experiences and Build Long-Lasting Customer Relationships**

Remote, USA Full-time

Flagstaff, AZ - Medical - Healthcare - AZDVS - ASVH-Flagstaff - LPN

Remote, USA Full-time

NetSuite ACS Functional Consultant

Remote, USA Full-time

Entry-Level Data Entry Specialist – Launch Your Career in Data Management with blithequark

Remote, USA Full-time

Remote Community Policy Manager – Privacy, Data Protection & Human Rights Strategy Lead for Global Platform

Remote, USA Full-time

Project Manager, Product Transfer

Remote, USA Full-time

Advertising Agent

Remote, USA Full-time

Wholesale Representative

Remote, USA Full-time

Litigation Docket Administrator (Temp) – LT11182024SFO_12-4658

Remote, USA Full-time

Digital Experience Strategy, Manager Washington D.C. - Remote

Remote, USA Full-time
Back to Home