5 jobs found in Bloomfield

Do you want to Improve the health and vitality of those we serve? EviCore, a line of business within the Cigna Group is hiring a Claims System Senior Analyst. This highly technical systems role requires the review of our claims processing system to ensure all configurations were input correctly into the system per the specifications of the provider. The Claims System Senior Analyst will have in depth knowledge of the eviCore claims systems and products. As the Subject Matter Expert, you'll partner with the Systems Configuration Associates, internal departments, external clients and vendors to ensure configurations have met client requirements and quality standards. What you'll do: Resolve non-routine issues escalated from leadership, business, clients and junior team members and act as a subject matter expert (SME) to business and IT for eviCore claims product setups/processes Collaborate with internal and external clients to understand, and evaluate processes,...

POSITION SUMMARY: This position is responsible for account receivable activity for a specific Provider Book of Business tied to an account management team. They will be a key partner to the Provider Relations Executives (PRE) and Managers (PRM) 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 Providers 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 Providers 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...

Provider Relations Lead Analyst | Encore - Cigna Retiree Program The Provider Relations Lead Analyst is a key member of National Ancillary Tools and Capabilities Team. This role will provide a variety of operational support functions within the team. This role will support the operational reporting, service processes, and invoicing with a focus on successful delivery of the highest value projects. In addition, this role will support operational functions across the team as part of on-going business process improvements, centralization and related responsibilities. As a member of the Tools and Capabilities team, this role entails analysis, root cause identification, and resolution. Responsibilities: Oversees the task of preparing vendor invoices; ensuring a complete, timely and accurate invoice package is sent to Accounts Payable Team for payment Inspects invoices for deficiencies Tracks the status of vendor invoices Investigates and resolves...

The Quality Review and Audit Lead Analyst supports Quality Control, Audit, and testing initiatives across client implementations, benefit changes, and ongoing business activities. This role focuses on executing defined test plans, validating benefit configuration and data accuracy, documenting defects, and supporting testing timelines in alignment with established methodologies and guidance. Applying analytical thinking, attention to detail, and foundational subject matter knowledge, the Analyst helps identify issues, validate expected outcomes, and support accurate delivery of client and regulatory requirements. Working in a collaborative, fast-paced environment, the Analyst partners with implementation, account, operations, and product teams-under the direction of Advisors and Senior Advisors-to ensure test execution aligns with defined requirements and business objectives. The role also contributes to operational readiness and continuous improvement by following...

This is a #Hybrid role requiring 3 days per week in the office , based in an EST or CST location. You will generate data and insights in support of category management and sales projects and initiatives (including category reviews, new item presentations, scorecards, assortment/shelving, and ad-hoc analytics). Essential Functions: Provide analytical support for category management and sales projects and initiatives utilizing various CPG and Retailer data sources and tools . Responsible for quality control of data sources and ensuring accuracy of deliverables , often requiring engagement with other BI associates and data/tool vendors. Build and update weekly and monthly dashboards and provide insights Participate in the development of sales presentations incorporating syndicated data and other sources of data that address business issues. Work closely with business managers to ensure quality results are delivered Keep abreast of...