Accounts Receivable Manager - Provider Relations Lead Analyst - Cigna Healthcare - Remote

SUMMARY

This position is responsible for account receivable activity for a specific Health Care Professional (HCP) Book of Business 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 AR Management

Collaborates with experience manager and matrix partners to identify, resolve and improve AR issue.

Key contributor to the development of the HCP strategic plan for an aligned BOB

Proactively monitors account receivable, performance guarantees and other AR related issues and communicates results to experience manager

Drives root cause analysis, trending related to AR resolution

Interacts directly with HCP to understand, educate, communicate and resolve AR issues

Participates in face to face meetings with EM as needed to act as an AR SME

Manages AR issue action plans 

Works with account management team to proactively make recommendations on changes to improve service levels based upon root cause

Supports service intent review process for specific BOB as defined by the SIR 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 (BOB)

Responsible for tracking and trending all AR related issues

QUALIFICATIONS

Bachelor's degree or higher strongly preferred or equivalent work experience required 

3+ years of experience in benefits and claims administration required

Advanced knowledge of Cigna claims (administration/processing/research) required

Strong experience using Proclaim required

Facets experience is preferred

Experience using Excel is required (basic skills)

Account management experience is required

Experience working with providers is required

Relationship management and/or project management experience highly preferred

Access knowledge helpful

Experience with provider contracting or loading 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

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.

Limited travel may be required (up to 10%)

CORE COMPETENCY

•          Organizational Agility

•          Presentation Skills

•          Written Communication

•          Timely Decision Making

•          Priority Setting

•          Time Management

•          Drive for Results

•          Decision Quality

•          Functional/Tech Knowledge

•          Negotiating

•          Customer Focus

•          Strategic Agility

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/5Mbp