Claims Systems Configuration Lead Analyst

23 hours ago

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The Cigna Group

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10,000+

Description

• Drive growth and change lives as Claims System Configuration Lead Analyst at eviCore. • Act as the Subject Matter Expert (SME) for Claims Configuration and eviCore Claims Systems. • Support and lead client implementations and internal integration/migration efforts. • Analyze existing setups for opportunities to improve adjudication automation and accuracy. • Collaborate with technology and analytics teams for new data sources for reporting.

Requirements

• High School Diploma required, bachelor’s degree preferred. • 3+ years of experience as a subject matter expert for claims system configuration, processing, reporting, issue triage, and testing required. • Experience in creation of test plans/use cases to support end-to-end testing required. • Advanced experience with MS ACCESS required. • Advanced experience with MS EXCEL required. • Advanced experience with SQL and SQL querying required. • Experience with all MS office products including PowerPoint required. • 5+ years of healthcare claims life cycle experience, with emphasis in claims system requirements analysis and billing rule, benefits and provider configuration design required. • Must be highly productive in a fast-paced, dynamic organization and skilled in analyzing business and user requirements, translating them into proper system requirement specifications required. • Excellent written, oral communication, client-based communication skills and interpersonal skills required. • Client facing communication and presentation skills strongly preferred. • Knowledge of industry standard claims data types (837, 835, 277, 999) and editing rules preferred. • Knowledge of database management systems (DB2, SQL Server) preferred.

Benefits

• Comprehensive health-related benefits including medical, vision, dental. • Well-being and behavioral health programs. • 401(k) with company match. • Company paid life insurance. • Tuition reimbursement. • Minimum of 18 days of paid time off per year. • Paid holidays.