Cigna Healthcare · 8 hours ago

Claims Systems Configuration Quality Review Senior Analyst - eviCore - Remote

United States Work at Home

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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Claims systems configurationHealthcare claims lifecycleSQL queryingClaims adjudicationMicrosoft AccessMicrosoft ExcelDatabase management systemsCreating test plansSDLC modelsMC400McNetRC3 systemsClaims data typesEditing rules