This is a hybrid role that requires on-site presence 3 days/week in the Morris Plains, NJ office.
ESSENTIAL FUNCTIONS
Ensures all Regulated Market adjustments are reviewed and processed within CMS guidelines to ensure CMS and contractual guidelines related to turnaround times are met. This includes a financial analysis review of adjustment extract criteria, review of the impact report results, and financial reconciliation of adjustment processing to the closure of the adjustment request.
Responsible for the delivery of specific delegated tasks by the Financial Operations Manager; completes day-to-day financial operations tasks independently.
Creates reports in accordance with any applicable laws and regulations as well as in accordance with financial auditing controls.
May gather results and prepare reporting for distribution to clients/internal teams. Must have knowledge of Excel tools to create pivot reports and filters for required financial analysis.
May assist with triage, high dollar reviews, and daily file uploads, as needed.
Ensures all adjustments are accrued in the system timely and properly for direct assignments.
Resolves non-routine issues escalated from internal cross-functional partners and communicates directly with the requestors of adjustments, including client service delivery, product and account management.
QUALIFICATIONS
Must be within driving distance to the Morris Plains, NJ office
Bachelor's degree in Finance, Accounting, Statistics, Business or other related field or equivalent work experience
2+ years relevant experience in finance, claims adjudication, or project management preferred
Experience in Healthcare, Insurance, Pharmacy, Medicare, Medicaid, CMS highly preferred
Advanced Excel skills, including experience with large data sets, pivot tables, VLookup, and macros
Experience with Power BI and Tableau a plus
Excellent problem solving skills and attention to detail
Ability to communicate effectively internally and cross functionally on both technical and non-technical aspects of the business
Excellent judgment, communication, interpersonal and organizational abilities
Ability to be flexible, agile, and manage complex processes
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 employee benefits programs, visit Life at Cigna Group.
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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.