Job Description
Ready 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
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.
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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.
Job Tags
Hourly pay, Holiday work, Permanent employment, Local area, Remote job, Work from home,