Cigna HealthcareRemote
Business Project Senior Analyst, MRC Manual Pricing - Cigna Healthcare - Remote
United States of America
Full Time
1 day ago
$66,000 - $110,000 USD
H1B Sponsor Likely
Key skills
Claims analysisPricingReimbursementHealthcare operationsMicrosoft ExcelMicrosoft WordMicrosoft PowerPointMicrosoft SharePointHealthcare claim payment methodologiesClaims systemsAnalytical skillsIndependent decision-makingPrioritizationCommunication
About this role
Cigna Healthcare is an advocate for better health through every stage of life. This role plays a critical part in supporting non-participating cost containment efforts by ensuring accurate, timely, and thoughtful manual pricing decisions while collaborating with experienced professionals to evaluate complex claims.
Responsibilities:
- Perform manual pricing for Maximum Reimbursable Charge (MRC1/MRC2) claims, ensuring accuracy, compliance, and alignment with pricing guidelines
- Analyze complex, sensitive, or escalated claims and recommend pricing outcomes that balance cost containment with customer experience
- Evaluate system and process challenges, identifying practical solutions that improve efficiency, accuracy, and overall results
- Provide clear analysis, pricing rationale, and guidance to internal and external partners requesting manual pricing support
- Take informed, decisive action on priority issues while managing multiple requests in a fast-paced environment
- Contribute to continuous improvement by sharing knowledge, strengthening functional expertise, and supporting team learning
- Support quality and accuracy initiatives that enhance appeal outcomes and improve member and provider experiences
Requirements:
- 3+ years of experience in claims analysis, pricing, reimbursement, or related healthcare operations role
- Strong analytical and problem-solving skills, with the ability to assess complex data and make sound recommendations
- Experience working in fast-paced environments requiring prioritization, independent decision-making, and attention to detail
- Strong written and verbal communication skills, with the ability to explain pricing decisions clearly and professionally
- Proficiency with Microsoft Office tools, including Excel, Word, PowerPoint, and SharePoint
- Knowledge of healthcare claim payment methodologies and reimbursement practices
- Experience with claims systems such as Proclaim, PMHS, Facets, or SANP
- Experience supporting pricing strategy, appeals, or reimbursement analysis