EDI Claims Support Senior Analyst - eviCore - Remote

Ready to improve the health and vitality of those we serve? EviCore a line of business within The Cigna Group is hiring an EDI - Claims Support Senior Analyst. For this highly specialized, Electronic Data Exchange configuration / mapping role, you’ll independently monitor, assist, research, and troubleshoot business to business Electronic Data Interchange (EDI) claims system inquires, including the following:

What you’ll do to make a difference:

• Define business and technical data exchange requirements.

• Research and determine any data file mapping issues and correct

• Monitor, assist, research, and troubleshoot business to business claims EDI file exchanges

• Lead large scope projects as related to their role

• Review and resolve various critical errors on inbound/outbound claims submissions.

• Validate and perform claims inventory reconciliation

• Assist internal departments with claim submission questions and research 

• Provide internal support on testing and troubleshooting new and existing mapping configurations

• Provide external support on testing and troubleshooting new and existing direct submitters 

• Respond to internal and external EDI Claims Support related inquiries

• Assists in providing support and training to other team members

REQUIREMENTS:

• High School diploma or GED, Required; bachelor’s degree, Preferred

• 7+ years of experience with healthcare claims life cycle experience, emphasis in X12 EDI Claims Files (such as 837P, 837I, 999, 277CA, 835), Strongly Preferred

• 5+ years of experience managing EDI - Electronic Data Exchange files for multiple platforms / systems, Required

• 3+ years of claims configuration experience, Required

• Intermediate level knowledge of Microsoft Word, Excel, and Access, Required

• 3+ years of experience with SQL querying, Required

• Knowledge of internal systems; MC400, PLEXIS, MCRS and MCNET, Preferred

• Strong technical skills, Required

• Strong analytical skills, Required

• Strong organizational skills and attention to detail, Required

• Must be able to work independently, Required

• Proven ability to perform well in a production environment, Required

• Excellent written and oral communication skills, Required

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.

For this position, we anticipate offering an annual salary of 51,200 - 85,400 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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