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Claims System Analyst - Work from home - eviCore

Company: Cigna
Location: Franklin
Posted on: June 2, 2021

Job Description:

US Remote, Work from home

The Claims Systems Analyst (CSA) position has adept knowledge in the eviCore Claims Systems and suite of eviCore Claims Products. The CSA will provide support to Claims Systems Configuration Administrator/Coordinator associates and other internal departments, as well as, external clients and vendors

This position will be the primary associate for new product, or complex (multi-product and/or multi-state) eviCore claims systems client implementations and internal integration/migration efforts, as well as, change requests, design documentation creation and/or approval, and support the Claims Systems Director in production release approvals.

Responsibilities related include:

  • define business, technical and claim data exchange requirements

  • instruct on data file mapping (such as provider, member, auths, claims, etc.)

  • designing solutions and system configuration

  • creating test/use cases

  • SI testing

  • providing support for associated UA testing, as related to their SME role, to ensure proper interaction for current and future claims product use

The CSA will be responsible for collaboration and oral/written communication with internal and external client business operations, IT departments and QA departments to support these requirements.

Additional responsibilities may include reporting development, RFP data processing requests, training, maintenance transition and process/product workflow/documentation.

This CSA will perform duties under self-direction and have decision making responsibilities.

Minimum Education, Licensure and Professional Certification requirement:

  • Bachelor's degree in business, healthcare or computer related field.

Minimum Experience required (number of years necessary to perform role):

  • 5+ years of healthcare claims life cycle experience, emphasis in claims system requirements analysis and configuration design is preferable

  • Experience with MC400 is strongly preferred

Required Skills:

  • Accomplished in claims lifecycle knowledge, requirements analysis, configuration design, written and oral communication skills, interpersonal skills, claims adjudication framework, client based communication skills and industry standard claims data types and editing rules (ICD, CPT/HCPC, Rev Codes, NCCI).

  • Knowledge of SQL querying and Microsoft office suite.

  • Familiarity with database management systems (DB2, SQL Server), creating test plans/use cases, and SDLC models.

This position is not eligible to be performed in Colorado.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

Keywords: Cigna, Franklin , Claims System Analyst - Work from home - eviCore, Other , Franklin, Tennessee

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