Claims Systems Configuration Senior Analyst - eviCore - Remote

Do you want to Drive Growth and Improve Lives? Do you have advanced technology skills with Claims Systems Configuration, SQL querying, MS Access, Excel and database management? Then read on...

EviCore, a division of The Cigna Group is hiring a Claims Systems Configuration Senior Analyst.

For this senior level role, you'll be responsible to resolve escalated systems issues from leadership, business, clients and junior team members and act as a subject matter expert (SME) to the business and IT for eviCore claims product setups and processes.

What you'll do to make a difference:


* Provides direction and guidance to the team regarding policies, procedures, workflows, and claims service quality



* Completes day-to-day Configuration tasks without immediate supervision but has ready access to advice from more experienced team members



* Analyze complex business requirements to configure claim rules within the functionality of the system and responsible for monitoring claim service standards



* Manage the accurate and timely additions of claims rules and administers disposition according to requirements and company policies and procedures



* Communicates and educates regarding issues/trends to minimize errors



* Resolves non-routine issues escalated from more junior team members

What you'll need to succeed:


* High School Diploma or GED Required


* 5+ years of healthcare claims lifecycle; configuration design, editing, claims system requirements, and analysis Required


* 3+ years of ADVANCED experience in Microsoft ACCESS and EXCEL REQUIRED


* 3+ years of ADVANCED experience with SQL querying, database management systems REQUIRED


* 3+ years creating test plans/use cases, and SDLC models required


* 3+ years of experience with AS400, MC400, McNet and RC3 systems required preferred


* 3+ years of experience with claims adjudication, claims data types and editing rules (ICD, CPT/HCPC, NCCI, MPPR, OPPS, RBRVS, FFS)

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 51,500 - 85,800 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 empl...