Business Project Senior Analyst - Cigna Healthcare - Remote

About this role

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 Cignas vendor partners to assist them in maximizing post payment recovery efforts.

Responds timely to complex share point 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 trouble shoots 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.
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