Plan Automation Senior Associate Evernorth Remote (Chattanooga, TN)
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Job Location:
Chattanooga, TN - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
POSITION SUMMARY
As a Plan Automation Senior Associate you will utilize Implementation materials to load client specific benefits in the Proclaim claim engine using macro/BOT technology and manual system entry to support new and existing business.
You will also ensure that account benefits are in compliance with Federal and State legislation.
This position will have the flexibility to perform fully remote. However it is required that candidates must reside within a 50-mile commute to the Cigna office facility at 401 Chestnut Street Chattanooga TN 37402.
What you will do
- Review and analyze various documents; such as contract language ePro benefit summaries and state mandates to ensure the claim engine is in compliance with client intent and benefit standards
- May be involved in benefit review discussions with Proclaim subject matter experts (SMEs) to provide insight on account specific benefit load or live claim payment inquiries from internal partners
- Prevent access to care (ATC) issues and resolve member impacting benefit disjoints by updating the claim engine timely based on updated source documents and/or benefit load clarifications
- Internally communicates workflow and quality improvement processes when identified
What you will need:
- High School Diploma or GED
- 2 years experience in benefits call center customer service preferred
- Intermediate knowledge of MS Office products specifically MS Excel required
- Ability to multi-task and effectively navigate within multiple systems simultaneously required
- Excellent communication skills (oral and written); inclusive of accurately documenting system updates
- Strong analytical organization and problem-solving skills
- Strong time and inventory management skills
- Ability to learn on the fly and function in a fast paced and changing environment
- Ability to interpret process and implement complex information
- Ability to accurately self-audit completed system updates
- Ability to prioritize and meet deliverables within expected timing
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.
About The Cigna Group
Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group were dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race color age disability sex childbirth (including pregnancy) or related medical conditions including but not limited to lactation sexual orientation gender identity or expression veteran or military status religion national origin ancestry marital or familial status genetic information status with regard to public assistance citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you need a reasonable accommodation to complete the online application process please email for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama Alaska Arizona Arkansas Delaware Florida Georgia Hawaii Idaho Iowa Kansas Maryland Massachusetts Michigan Nebraska Ohio Pennsylvania Texas Utah Vermont and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal state and local ordinances.
Required Experience:
Senior IC
Key Skills
About Company
Cigna Healthcare offers health insurance plans such as medical and dental to individuals and employers, international health insurance, and Medicare coverage.
