Overview: As a member of the Provider Solutions and Operations team, this role Serves as a key member of the Provider Solutions Circle of Excellence (PSCOE) responsible for providers’ Accounts Receivable Management activity for Non-Dedicated Providers for commercial lines of business.  This is an externally facing role.

Responsibilities: Ensures timely and accurate claims administration, monitors results, and leverages resources and tools to assist providers in managing their accounts receivables Responsible for tracking and trending all accounts receivable related issues timely and accurately in appropriate tools Ensure provider satisfaction for all claim project results Collaborates with local market matrix partners to identify, resolve and improve Accounts Receivable issues Contributes to provider strategic action plans for assigned markets; as requested Drives root cause analysis and trending related to Accounts Receivable resolution Serves as Subject Matter Expert internally and externally on claim processing and reimbursement policies Communicates and educates regarding issues/trends to minimize errors and improve claim accuracy Interacts directly with provider to understand, educate, communicate and resolve accounts receivable issues Participates in provider meetings with local team to act as an Accounts Receivable Subject Matter Expert as requested Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause Engages matrix partners to achieve service improvements and minimize contract interpretation issues Provides direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs. Participates in cross functional project initiatives and workgroups, as requested Achieves and/or exceeds Service Level Agreements

Qualifications: College degree or equivalent work experience Advanced knowledge of proclaim claim and supporting systems Proficient in Excel Experience with Cigna claim processing, claim appeals, or claim quality preferred Demonstrated ability to successfully interact with both internal and external customers at all levels Demonstrated ability to perform root cause analysis on claims issues Demonstrated ability to manage and resolve problems to satisfactory completion Skills to include time management, task analysis and breakdown and resource utilization Demonstrated ability to present detailed technical information to a less knowledgeable audience and negotiate resolutions in a mutually beneficial manner to both CIGNA and the provider Demonstrated ability to see the "big picture" - understand how each phase of the claims payment process affects the end result and provider satisfaction Demonstrated ability to handle confrontational situations in a professional manner ending in a better partnership between CIGNA and the provider Demonstrated ability to take ownership of tasks/projects and perform work under minimal supervision with exceptional outcomes Demonstrated ability to read and understand data results