Job description

Position Summary

As a Plan Automation Senior Associate, you will utilize Implementation materials to load client specific benefits in the Proclaim claim engine, using macro/BOT technology and manual system entry to support new and existing business. You will also ensure that account benefits are in compliance with State and Federal legislation.

"REMOTE OPPORTUNITY" - Training is required onsite for 12 weeks

What you will do:
Review and analyze various documents; such as, contract language, ePro, benefit summaries, and state mandates to ensure the claim engine is in compliance with client intent and benefit standards

May be involved in benefit review discussions with Proclaim subject matter experts (SMEs) to provide insight on account specific benefit load or live claim payment inquiries from internal partners

Prevent access to care (ATC) issues and resolve member impacting benefit disjoints by updating the claim engine timely based on updated source documents and/or benefit load clarifications

Internally communicates workflow and quality improvement processes when identified

What you will need:
High School Diploma or GED

Intermediate knowledge of MS Office products, specifically MS Excel

Knowledge of Proclaim system

Excellent written communication skills; inclusive of accurately documenting system updates made

Strong verbal communication skills

Strong analytical and problem solving skills

Strong organizational skills

Strong time and inventory management skills

Ability to “learn on the fly” and function in a fast paced and changing environment

Ability to interpret, process, and implement complex information

Ability to accurately self-audit completed system updates

Ability to prioritize and meet deliverables within expected timing

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.

About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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.

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