Responsible for Medicare CIM Data and Demographics such as our directory and direct loads. Providing back up to our CIMS as well as our electronic feed team.
Learning all of the nuances for our National Ancillary Providers.
Working along side of our CIMS on reports and audits and other audit teams.
Provide recommendations for process improvements and elimination of barriers, obstacles and risks and assists with delivery and implementation of solutions using our nuances and various tools for the National Ancillary Team.
Responsibilities
Perform tasks such as research fall out issues.
Follow up with the manager on infractions monthly.
Able to understand the interdependencies among business systems, teams and matrix partners; recognizes when changes or additional analysis needs to be conducted and to provide appropriate feedback and suggestions.
Participate in peer training and coaching support to obtain required processing knowledge.
Participate in workload balancing daily as needs arise to support work streams and functions
Understands and supporting National Teams, both CIMS and electronic Feed teams.
Understand and follow all loading instruction, policy and procedure documentation. Continually identify and escalate process gaps and opportunities for process efficiencies across documentation to avoid negative customer impacts.
Initiate accurate problem identification and present root cause analysis findings utilizing appropriate data trending tools and resources. Collaborate to implement corrective actions.
Meet deadlines and accept additional tasks and assignments while maintaining established quality, production, and team timeliness standards.
Able to work successfully in a team environment.
Able to work and collaborate with matrix partners to provide regular data performance feedback, close data integrity gaps and proactively seek resolutions.
Qualifications
Bachelor’s degree or higher preferred or equivalent work experience. Prior experience in the healthcare industry and knowledge of medical terminology (or any combination of education and work experience) also preferred.
Be proficient in Microsoft Word and Access (helpful)
Excel experience is helpful (such as manipulating the files & pivot tables)
Prior claim exposure/experience preferred.
PWB loading experience preferred.
Working knowledge of, and/or experience with coding and reimbursement methodologies.
Prior experience with provider data loading preferred. Understand how contract set up and current business policies and technology will affect claim payments. preferred
Proven ability to maintain positive working relationships, receiving and providing feedback, coaching and guidance to/from other staff members.
Self-starter with proven technical, analytical, negotiating, problem-solving, organizational and time management skills. Self-motivated, detail oriented, decisive, and adaptable to change
Aptitude in demonstrating the ability to maintain a high level of focus and attention to detail while working with complex data and systems
Ability to function well in a fast-paced, demanding environment.
Must be able to effectively communicate with others.
Ability to work independently while managing multiple tasks and meeting deadlines while also being a strong team player, partnering with others to collaboratively resolve issues and deliver solutions.
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.
For this position, we anticipate offering an hourly rate of 23 - 34 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
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.
Please Note :
www.bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
Learning all of the nuances for our National Ancillary Providers.
Working along side of our CIMS on reports and audits and other audit teams.
Provide recommendations for process improvements and elimination of barriers, obstacles and risks and assists with delivery and implementation of solutions using our nuances and various tools for the National Ancillary Team.
Responsibilities
Perform tasks such as research fall out issues.
Follow up with the manager on infractions monthly.
Able to understand the interdependencies among business systems, teams and matrix partners; recognizes when changes or additional analysis needs to be conducted and to provide appropriate feedback and suggestions.
Participate in peer training and coaching support to obtain required processing knowledge.
Participate in workload balancing daily as needs arise to support work streams and functions
Understands and supporting National Teams, both CIMS and electronic Feed teams.
Understand and follow all loading instruction, policy and procedure documentation. Continually identify and escalate process gaps and opportunities for process efficiencies across documentation to avoid negative customer impacts.
Initiate accurate problem identification and present root cause analysis findings utilizing appropriate data trending tools and resources. Collaborate to implement corrective actions.
Meet deadlines and accept additional tasks and assignments while maintaining established quality, production, and team timeliness standards.
Able to work successfully in a team environment.
Able to work and collaborate with matrix partners to provide regular data performance feedback, close data integrity gaps and proactively seek resolutions.
Qualifications
Bachelor’s degree or higher preferred or equivalent work experience. Prior experience in the healthcare industry and knowledge of medical terminology (or any combination of education and work experience) also preferred.
Be proficient in Microsoft Word and Access (helpful)
Excel experience is helpful (such as manipulating the files & pivot tables)
Prior claim exposure/experience preferred.
PWB loading experience preferred.
Working knowledge of, and/or experience with coding and reimbursement methodologies.
Prior experience with provider data loading preferred. Understand how contract set up and current business policies and technology will affect claim payments. preferred
Proven ability to maintain positive working relationships, receiving and providing feedback, coaching and guidance to/from other staff members.
Self-starter with proven technical, analytical, negotiating, problem-solving, organizational and time management skills. Self-motivated, detail oriented, decisive, and adaptable to change
Aptitude in demonstrating the ability to maintain a high level of focus and attention to detail while working with complex data and systems
Ability to function well in a fast-paced, demanding environment.
Must be able to effectively communicate with others.
Ability to work independently while managing multiple tasks and meeting deadlines while also being a strong team player, partnering with others to collaboratively resolve issues and deliver solutions.
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.
For this position, we anticipate offering an hourly rate of 23 - 34 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
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.
Please Note :
www.bankofmontserrat.ms is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.bankofmontserrat.ms provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.