The Cigna Group · 2 days ago
Claims System Configuration Senior Analyst - eviCore - Remote
United States
Full-time
Remote
Senior Level
$51K/yr - $85K/yr
5+ years exp
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Responsibilities
Resolve non-routine issues escalated from leadership, business, clients and junior team members and act as a subject matter expert (SME) to business and IT for eviCore claims product setups/processes
Collaborate with internal and external clients to understand, and evaluate processes, procedures, job aids and identify solutions for procedural gaps
Analyze business and user requirements to design solutions and system configurations, specifications, create test plans/use cases perform SI testing, end to end testing and continuously improve adjudication automation and accuracy.
Partner with technology and analytics teams to develop new data sources for reporting and act as liaison between business and technology to execute project initiatives, and resolve issues
Qualification
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Required
High School Diploma or GED required, bachelor’s degree preferred
5+ years of healthcare claims lifecycle; configuration design, editing, claims system requirements, and analysis - REQUIRED
3+ years of experience in MS ACCESS - REQUIRED
3+ years of advanced experience with MS EXCEL - REQUIRED
3+ years of experience with SQL and SQL querying, REQUIRED
3+ years of experience with database management systems, creating test plans/use cases, and SDLC models, required
3+ years of experience with claims adjudication, claims data types and editing rules (ICD, CPT/HCPC, NCCI, MPPR, OPPS, RBRVS, FFS)
Preferred
3+ years of experience with MC400, McNet and RC3 systems
Benefits
Medical
Vision
Dental
Well-being and behavioral health programs
401(k) with company match
Company paid life insurance
Tuition reimbursement
A minimum of 18 days of paid time off per year
Paid holidays
Company
The Cigna Group
The Cigna Group is a healthcare firm that focuses on providing hospital services and innovative solutions for better health.
10,001+ employees
Funding
Current Stage
Late StageLeadership Team
David Cordani
Chairman and Chief Executive Officer
Recent News
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