Job Description

Responsibilities:

• Own the end-to-end processes for managing inventory and escalations within the assigned region.

• Review, triage, and assign escalations to the appropriate resource based on issue type and urgency.

• Monitor team inventory and escalation volumes to ensure service level expectations are met.

• Conduct root cause reviews of repeated issues and partner with leadership to address process gaps.

• Assist in developing and training new staff in the escalation process of standard work and role expectations.

• Collaborate on knowledge exchange article updates and process efforts.

• Prepare weekly and monthly reporting on trends backlog and resolution timelines.

• Conduct regular one-on-one with direct reports to support their professional development and address roadblocks.

• Host team meetings to reinforce standard work, escalation awareness, and identify support opportunities.

• Ensure clear communication collaboration with market stakeholders and support resolution transparency.

• Provide weekly and monthly reporting to the director on escalation trends, backlog status, and team performance health.

• Participate in staffing coverage planning and cross regional support models.

• Promote team morale, accountability, and a culture of continuous improvement.

• Interacts directly with the provider to understand, educate, communicate and resolve issues.

• Participate in provider meetings with local team as needed.

• Provides direction and guidance regarding policies, procedures, workflows, claim service quality, and training needs.

• Participates in cross functional project initiatives and workgroups, as requested

• Achieves and/or exceeds Service Level Agreements

Qualifications:

• Bachelor's degree or higher strongly preferred or equivalent work experience required

• 3+ years of leadership, technical coaching or supervisory experience in healthcare revenue cycle operations preferably in Accounts Receivable or Provider Relations required

• Strong understanding of escalation workflows, claim resolution, and providers support processes

• Proven track record of cross functional communication and stakeholder engagement

• Experience managing global offshore teams in a shared service model

• Ability to conduct root cause analysis identify trends and drive resolution

• Proficient in Excel, and other workflow management tools.

• Experience with other MS Office Suite applications(Word, Outlook, etc.)

• Skilled in coaching, mentoring and developing performance evaluations

• Excellent communication, organization and time management abilities

• Experience with Cigna claim processing, claim appeals, or claim quality preferred

• Demonstrated ability to successfully interact with both internal and external customers at all levels

• Demonstrated ability to perform root cause analysis on claims issues

• Demonstrated ability to manage and resolve problems to satisfactory completion

• Skills to include time management, task analysis and breakdown and resource utilization

• Demonstrated ability to present detailed technical information to a less knowledgeable audience and negotiate resolutions in a mutually beneficial manner to both Cigna and the provider

• Demonstrated ability to see the "big picture" - understand how each phase of the claims payment process affects the end result and provider satisfaction

• Demonstrated ability to handle confrontational situations in a professional manner ending in a better partnership between Cigna and the provider

• Demonstrated ability to take ownership of tasks/projects and perform work under minimal supervision with exceptional outcomes

• Demonstrated ability to read and understand data results

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 70,300 - 117,100 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.

At The Cigna Group, 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), 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, click here ( .

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.

Job Tags

Similar Jobs