United States onlyReady to improve the health and vitality of those we serve? EviCore, a division of The Cigna Group is hiring a Claims System Configuration Associate. 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 Azure DevOps system 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
Requirements:
High school diploma or GED required, associate degree in a computer related field, preferred
2+ years of claims and health care data experience, required
1+ years of experience in medical claims systems configuration, preferred
Experience running simple queries utilizing Microsoft SQL, preferred
Experience in Microsoft Access database (including queries and data manipulation), preferred
Proficient in Microsoft Excel (including pivot tables, charts and formulas), required
Strong technical competence, proven critical thinking, and impeccable communication skills, required
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 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 require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] 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.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
