About The Position

In this role, you will be a key contributor to Cigna's Out of Network Protection Team (ONPT). We are seeking a highly skilled and meticulous Senior Analyst who can adapt quickly and deliver results within specified time limits. This analyst will play a critical role in resolving pricing inquiries for state and federal arbitration requests, along with pricing maintenance of ground ambulance established rates throughout various states.

Requirements

  • 3+ years of experience in healthcare analytics or provider pricing.
  • Demonstrated knowledge of MRC, FairHealth pricing, and Medicare base pricing.
  • Knowledge of provider claim payments.
  • Experience and knowledge of claim pricing platforms, including Proclaim, PMHS, Facets, PEGA and SANP.
  • Excellent communication, organization, and leadership skills.
  • Must be initiative-taking and possess the competencies required to work in a fast-paced entrepreneurial organization with critical turnaround time and compliance deadlines.
  • Exhibit strong organizational and critical thinking skills necessary to accomplish identified tasks within a specified time limit.
  • Ability to work independently and manage multiple priorities in a production-driven environment.
  • Proficient with Microsoft Office Suite (SharePoint, PowerPoint, Word, Excel)
  • 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.

Responsibilities

  • Manage the assigned caseload of pricing intakes within the established turnaround times for each pricing request.
  • Research and return pricing requests for State and Federal arbitration requests.
  • Maintain ongoing published pricing related to ground ambulance regulatory requirements by monitoring and updating published rates from state websites.
  • Improve provider experience by providing accurate results of intake requests and ground ambulance pricing.
  • Exhibit quick, decisive, and informed actions on issues or problems deemed critical.
  • Research problems to resolve complex and/or escalated and sensitive issues.
  • Demonstrate passion for self-motivation, initiative-taking, learning, and knowledge sharing.
  • Define and provide information and analysis to internal partners requesting pricing, guidelines, and analysis.
  • Participate in additional projects related to ONPT as requested.

Benefits

  • 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service