Plan Automation Senior Associate - Chattanooga, TN - Onsite

Must reside within 50-mile radius of 401 Chestnut Street Chattanooga, TN 37402.

Must successfully complete 10 weeks of training to proceed with position. The first 3 - 4 weeks will be onsite at 401 Chestnut Street Chattanooga, TN 37402.

Overtime required during peak seasons with limited time off during this time. 

POSITION SUMMARY:

Utilize Implementation materials to load client specific benefits in the Proclaim claim engine, using macro/BOT technology and manual system entry to support new and existing business. The Plan Automation Senior Associate will also ensure that account benefits are in compliance with State and Federal legislation.

WHAT YOU’LL DO:

• Utilize Implementation materials to load client specific benefits in the Proclaim claim engine to support new and existing business.

• Review and analyze various documents; such as, contract language, ePro, benefit summaries, and state mandates to ensure the claim engine is in compliance with client intent and benefit standards.

• May be involved in benefit review discussions with Proclaim subject matter experts (SMEs) to provide technical insight as requested from internal matrix partners.

• Prevent access to care (ATC) issues and resolve member impacting benefit disjoints by updating the claim engine timely based on updated source documents and/or benefit load clarifications

• Internally communicates workflow and quality improvement processes when identified.

• Learn on the fly and function in a fast paced and changing environment.

• Actively participate in stretch assignments and remediation initiatives.

WHAT YOU NEED TO DO THIS JOB:

• High School Diploma or GED required

• 2 years customer service background; call center experience is a plus

• Intermediate knowledge of MS Office products, specifically MS Excel required

• Excellent written communication skills; inclusive of accurately documenting system updates made

• Ability to multitask required

• Strong verbal communication, analytical and problem-solving skills

• Strong organizational, time and inventory management skills

• Ability to interpret, process, and implement complex information and to accurately self-audit completed system updates

• Ability to prioritize and meet deliverables within expected timing

• Experience working independently

• Knowledge of matrix partner functions and how they interact; preferred

• Appropriately use MOS tools including DPL (inventory tracking system)

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.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.