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