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This is a hybrid role with on-site presence required
POSITION SUMMARY
The Enrollment/Billing Senior Advisor works strategically with Accredo Revenue Cycle Management (RCM) Collections partners to identify risk and opportunity for a payor that has decreased cash flow, accounts receivable collections challenges, and increased aging that is impacting Accredo’s financial performance. Through this review, the Senior Advisor role will be responsible for engaging a variety of Cigna matrix partners (e.g Account Management Team, Contracting, Underwriting, Accredo Collections, Vendor Management, Clearance, Legal/Compliance, Finance, Accounting) and the appropriate payor points of contact to resolve the issues preventing timely and accurate claim payment. The Senior Advisor will lead/facilitate internal and external-facing meetings, lead multi-functional projects, perform financial and operational analyses, report out findings to key stakeholders, deliver on process improvements, make financial reserve recommendations to Accounting, and resolve operations issues within Accredo and with payors. During discussions with a payor, if the reason identified for collections challenges is directly linked to Accredo process, it is the responsibility of the Senior Advisor to collaborate internally and drive solutions that will reduce payer-denied claims and mitigate bad debt.
ESSENTIAL FUNCTIONS
Financial focus on decreasing and mitigating bad debt and managing payer accounts receivable.
Excellent verbal and written communication and presentation skills.
Detail oriented with strong organization skills.
Ability to collaborate across multiple stakeholders and work streams to resolve root causes issues impacting receivables.
Strong project management skills to achieve cross-functional results.
Build and develop client-facing relationships that are key to identifying and resolving complex issues that are impacting collections and/or contributing to bad debt.
Understanding/identifying internal operational processes that may lead to bad debt, identify appropriate opportunity for improvement and increase profitability at both the drug and payor level.
Identification of Accounts Receivables at risk of non-payment, and basic understanding of financial payor reserves and bad debt impacts (ie. improper authorizations, incorrect benefit billed, incorrect payor).
Preparation, review, and presentation of bi-weekly and monthly payor risk analysis with internal partners, including Account Management, RCM, Finance and Accounting.
Basic understanding of contracts and ability to make recommendations to improve cash flow.
Support reporting needs associated with accounts receivables for quarterly business reviews with the payor and account team.
Coordinate settlements between Accredo and payors as needed which includes owning the spreadsheets with the payors, owning communications of reserve, working with the Account Management team on legal considerations, coordinating the posting of the payment, and submitting the adjustments for Boston Workstation (RPA) processing.
Working knowledge of MS products (excel/PowerPoint, Word, Visio & OneNote) and Tableau. Alteryx knowledge preferred.
Willingness to travel 10-20%
QUALIFICATIONS
4 years relevant work experience or BA/BS degree.
Financial Acumen.
End to end/cross-functional process improvement orientation.
Ability to extract, analyze, synthesize and report on large quantities of data.
Comfortable with data modeling and reporting tools.
Adept at working in a fast-paced work environment and is adaptable to the changing needs of the business.
Advanced problem-solving and analytical skills.
Ability to make informed decisions independently with imperfect information.
Ability to manage multiple priorities, drive results, execute and deliver timely.
Knowledge of pharmacy operations, processes and business model strongly preferred.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Other | Full Time
$61k-78k (estimate)
05/20/2024
05/23/2024
cigna.com
CHASKA, MN
>50,000
1982
Public
LARRY SHAFRANSKI
>$50B
Cigna offers health, dental, Medicare and supplemental insurance plans to consumers and employers.