Accounts Receivable Manager - Cigna Healthcare - Remote

The job profile for this position is Provider Relations Lead Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. POSITION SUMMARY: The Accounts Receivable Manager (Provider Relations Lead Analyst) is responsible for account receivable activity for a specific Health Care Professional (HCP) Book of Business (for the Mid-West/Mid-America Market) tied to an account management team. They will be a key partner to the experience manager supporting strategic planning to improve provider experience. Ensures timely and accurate claims administration, proactively monitors results, and leverages resources and tools to assist Health Care Professionals in managing their accounts receivables. Provides direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs. Regularly meets with assigned Health Care Professionals to discuss results, review issue trends, and develop action plans for improvement. Engages matrix partners to achieve service improvements and minimize contract interpretation issues. Communicates and educates internally regarding issues/trends to minimize errors and improve claim accuracy. They monitor contractual performance guarantees and LPI to minimize financial impacts.

• DUTIES AND RESPONSIBILITIES
• Serves as a key member of the account management team responsible for Accounts Receivable Management
• Collaborates with Accounts Receivable Manager and matrix partners to identify, resolve and improve Accounts Receivable issues
• Key contributor to the development of the provider strategic plan for an aligned book of business
• Proactively monitors account receivable, performance guarantees and other accounts receivable related issues and communicates results to Accounts Receivable Manager
• Drives root cause analysis, trending related to accounts receivable resolution
• Interacts directly with provider to understand, educate, communicate and resolve accounts receivable issues
• Participates in face to face meetings with Accounts Receivable Manager as needed to act as an accounts receivable Subject Matter Expert
• Manages accounts receivable issues/corrective action plans
• Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause
• Supports service experience review process for specific book of business as defined by the Service Experience Review strategy
• Contributes to market intelligence, documenting and sharing
• Achieves and or exceeds Service Level Agreements
• Responsible for all pre/post contract set up review for assigned book of business
• Responsible for tracking and trending all accounts receivable related issues timely and accurately in appropriate tools
• Ability to read and understand data results
• POSITION REQUIREMENTS
• Bachelor's degree or higher strongly preferred or equivalent work experience required
• 3+ years of experience in benefits and claims administration and/or relationship or project management experience
• Advanced knowledge of Proclaim required with Facets preferred.
• Excel experience required (pivot tables/VLOOKUP nice to have)
• Experience with provider contracting or loading
• 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
• Project management skills to include time management, task analysis and breakdown and resource utilization
• Strong facilitation and negotiation skills - 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.
• Some minimal travel may be required

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