Accounts Receivable Manager – Provider Relations Lead Analyst

Role Overview

• responsible for account receivable activity for a specific Health Care Professional (HCP) Book of Business tied to an account management team
• be a key partner to the experience manager supporting strategic planning to improve provider experience
• ensure timely and accurate claims administration
• proactively monitor results and leverage resources and tools to assist Health Care Professionals in managing their accounts receivables
• provide direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs
• regularly meet with assigned Health Care Professionals to discuss results, review issue trends, and develop action plans for improvement
• engage matrix partners to achieve service improvements and minimize contract interpretation issues
• communicate and educate internally regarding issues/trends to minimize errors and improve claim accuracy
• monitor contractual performance guarantees and LPI to minimize financial impacts

Requirements

• Bachelor's degree or higher strongly preferred or equivalent work experience required
• 3+ years of experience in benefits and claims administration required
• Advanced knowledge of Cigna claims (administration/processing/research) required
• Strong experience using Proclaim required
• Facets experience is preferred
• Experience using Excel is required (basic skills)
• Account management experience is required
• Experience working with providers is required
• Relationship management and/or project management experience highly preferred
• Access knowledge helpful
• Experience with provider contracting or loading preferred
• Demonstrated ability to successfully interact with both internal and external customers at all levels
• Demonstrated ability to perform root cause analysis on claims issues.
• Demonstrated ability to manage and resolve problems to satisfactory completion
• Project management skills to include time management, task analysis and breakdown and resource utilization
• Strong facilitation and negotiation skills
• demonstrated ability to present detailed technical information to a less knowledgeable audience and negotiate resolutions in a mutually beneficial manner to both Cigna and the provider.
• Demonstrated ability to see the "big picture"
• understand how each phase of the claims payment process affects the end result and provider satisfaction.
• Demonstrated ability to handle confrontational situations in a professional manner ending in a better partnership between Cigna and the provider.
• Demonstrated ability to take ownership of tasks/projects and perform work under minimal supervision with exceptional outcomes.
• Limited travel may be required (up to 10%)

Benefits

• comprehensive range of benefits
• health-related benefits including medical, vision, dental
• well-being and behavioral health programs
• 401(k)
• company paid life insurance
• tuition reimbursement
• a minimum of 18 days of paid time off per year
• paid holidays