Provider Contracting Senior Analyst

The role:

A specialist role to work within the UK Network team supporting Network Manager and Senior Analysts on both Network and Healthcode. This role is provider facing, requires the candidate to work directly to support providers and to maintain accurate coding on Healthcode to ensure the smooth flow of invoice data from UK Healthcare providers to our policy admin systems.

Responsibilities:

• Support Network team with provider issues

• Support Healthcode SME for end-to-end Healthcode Process as below

  • Maintenance of the ‘Group Code Sets’ hosted on Healthcode website

  • Amending and/or adding new Industry Standard Codes (ISC)

  • Maintenance of the Collibra Service code mapping including changing/adding new ISC codes and the associated PAS procedure code mapping

  • Maintenance of the Healthcode Validation Rules 

  • Main point of contact for all queries in relation to Healthcode provider coding queries (for the code sets outlined in this role specification)

  • Responsible for the submission/updates of price screening files for key UK providers

  • Maintenance of the ‘Valid CCSD’ code set

  • Maintenance of ‘Invalid Code Combinations’ code set

  • Understanding of how the settings impact data inflow

• Support providers in relation to Healthcode related queries as below

  • Invalid member details

  • Validation failures CCSD/ISC/patient data

  • Remittance advice

• Ensure Provider Database records are accurate and without duplicates to ensure the smooth flow of data

Reporting Line: Commercial Manager

Skills and Experience:

• Minimum of 2 years’ experience within a Customer Service/Claims/Medical team function

• Good knowledge of medical terminology

• Good knowledge of UK Providers and Provider processes

• Understanding of Benefit/Procedure code mapping

• Previous experience of working with external business partners and/or UK Healthcare providers

• Focused and highly organised with the ability to work to tight timelines

• Demonstrate the ability to perform root cause analysis

• Strong attention to detail

• Strong communication & facilitation skills

• Able to work independently or as part of a team

• Experience and competence with Microsoft applications – Excel is essential

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.