Ready to improve the health and vitality of those we serve? EviCore, a division of The Cigna Group is hiring a Claims System Configuration Associates. For this essential fast\-paced claims systems role, you'll manage simple to complex claims systems configuration within the claims adjudication engine. The Claims Systems Configuration Associate will ensure data integrity, data security and process optimization for eviCore claims processing. In addition, they will perform documentation and development of application functionality and data configuration.
Responsibilities:
* Configuration Associate will complete tasks with guidance (as needed) from mentor and/or Claims Configuration Supervisor
- Work from the Enterprise Jira platform utilizing project methodologies to maintain and upkeep tickets for claim system configuration requests
- Claims system configuration requests will include but are not limited to proprietary claim edits, industry standard claim edits, and benefit rules for all claim products and programs
- You'll review, coordinate, and outline claims system configuration changes to meet needed requirements
- Document configuration changes in Microsoft Excel checklist to confirm changes
- Test configuration changes to validate claims are processing based on requirements
- Utilize SQL queries to review configuration and claims data
- Make updates to configuration via Access database
- Run post\-production review on claims to validate changes deployed to production are processing as expected
- Investigate claim processing to determine claim configuration root cause analysis
- High school diploma or GED required; associate degree in a computer\-related field preferred
- Minimum of two (2\) years of experience working with claims or healthcare data required
- One (1\) year of experience of configuring medical claims systems required
- Demonstrated ability to write and run basic queries using Microsoft SQL Server, required
- At least one (1\) year of experience working with Microsoft Access database, including data manipulation, required
- Proficiency in Microsoft Excel, including the use of pivot tables, formulas, and charts, preferred
- Strong technical aptitude with demonstrated critical thinking abilities and excellent communication skills
Requirements:
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 22 \- 33 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.
At The Cigna Group, 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), 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, click here.
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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.