Cigna Provider Data Senior Associate - Nashville, TN (office based) in Nashville, Tennessee

Description:

SUMMARY:

The Network Operations Department is responsible for the financial and operational activities of the provider network. In this role, you will be exposed to all aspects of a Coordinated Care Organization (financial understanding, provider network building, conflict/issue resolution, contracting, claim payments, meetings, training, etc.). This role supports the Network Operations Administrators and Representatives.

RESPONSIBILITIES:

  • Researching and resolving provider issues such as authorization and claim issues
  • Identify the right parties or resources, internally and externally, to resolve issues timely.
  • Prepares documentation for meetings, schedules meetings, and educates providers regarding member benefits and the referral process
  • Develops, maintains, and distributes reports for assigned provider groups
  • Submitting change requests to update provider demographics, group information, contract changes)

Qualifications:

QUALIFICATIONS:

Minimum - Bachelor's Degree

Also Preferred:

  • Strong knowledge of healthcare insurance industry, terminology, provider networks, contracting and credentialing.
  • Ability and willingness to share knowledge.
  • Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).
  • Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.
  • Strong analytical and problem-solving skills.
  • Excellent communication skills – verbal, written and presentation.
  • Working knowledge of SharePoint, Microsoft Word, Excel, & Access.

Primary Location: Nashville-Tennessee

Work Locations: 601 Mainstream Drive Nashville 37228

Job: Provider--Network/Data Mgmt

Schedule: Regular

Shift: Standard

Employee Status: Individual Contributor

Job Type: Full-time

Job Level: Day Job

Travel:

Job Posting: Jun 13, 2018, 11:19:00 AM

Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com