Plan Automation Senior Associate - Evernorth - Remote (Chattanooga, TN)

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 required

• 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 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com 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.