Website Cigna
Job Description:
The Network Operations Department is responsible for the financial and operational activities of the provider network. In this role, you will be exposed to all aspects of a Coordinated Care Organization (financial understanding, provider network building, conflict/issue resolution, contracting, claim payments, meetings, training, etc.). This role supports the Network Operations Administrators and Representatives.
Job Responsibilities:
- Submitting change requests to update provider demographics, group information, contract changes)
- Develops, maintains, and distributes reports for assigned provider groups
- Identify the right parties or resources, internally and externally, to resolve issues timely.
- Researching and resolving provider issues such as authorization and claim issues
- Prepares documentation for meetings, schedules meetings, and educates providers regarding member benefits and the referral process
Job Requirements:
- Working knowledge of SharePoint, Microsoft Word, Excel, & Access.
- Strong analytical and problem-solving skills.
- Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.
- Excellent communication skills – verbal, written and presentation.
Qualification & Experience:
- Detail oriented, with proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards).
- Strong knowledge of healthcare insurance industry, terminology, provider networks, contracting and credentialing preferred
- Ability and willingness to share knowledge.
- Bachelor’s degree preferred
Job Details:
Company: Cigna
Vacancy Type: Full Time
Job Functions: Information Technology
Job Location: Nashville, TN, US
Application Deadline: N/A
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