Subrogation Analyst
6 months ago
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**Role Summary**:
As Subrogation Analyst within Payment Integrity FWA Team you will be directly supporting Cigna’s affordability commitment within Cigna International's business. This role is responsible to identify, investigate and seek recoveries for subrogation cases across Cigna’s Global claims platforms. This includes operating internal inter team processes to direct inbound requests for subrogation. He/ She will work closely with Payment Integrity FWA teams, Medical Economics, Data Analytics, Claims Operations, Clinical partners, Legal and Compliance, Account Management.
**Responsibilities**:
- Review claims and supporting documents to identify third party liability that caused injuries to Cigna insured.
- Ensure financial recoveries and prevention activities are being tracked and reported accurately.
- Interview customer, provider and/ or third-parties to establish liability and opportunity.
- Seek recovery of payments from third-parties responsible for the health damages caused to the insured or third-party insurer.
- Negotiate settlement agreements.
- Partner with Customer Services and Account Management on educating customers and clients regarding the subrogation rights and obtaining required documentation.
- Perform data-mining to reveal trends and patterns of subrogation cases.
- Partner with Cigna TPAs on subrogation cases.
- Partner with Payment Integrity and other teams to raise awareness of schemes that fall under subrogation scope.
- Working closely with other departments to ensure Payment Integrity activities do not have an unnecessary negative impact on our customers.
**Skills and Requirements**:
- You should enjoy working in a team of high performers, who hold each other accountable to perform to their very best.
- Experience in managing and/or negotiating recoveries/ refunds.
- Excellent verbal and written communication skills.
- Experience in subrogation is an asset.
- Experience and confidence in liaising with internal and external stakeholders.
- Commercial experience operating effectively under pressure and delivering results.
- Knowledge of Mainframe, Diamond, Actisure and/or Globalcare is preferred.
- Knowledge of claims coding, regulatory rules and medical policy.
- Medical/ paramedical qualification is a definite plus.
- Critical mind-set with ability to understand regulatory and legal context.
- Experience with data analytics is a plus.
- Demonstrated strong organization skills.
- Strong attention to detail.
- Ability to quickly learn new and complex tasks and concepts.
- Ability to balance multiple priorities at once and deliver on tight timelines.
- Flexibility to work with global teams and varying time zones effectively.
- Strong organization skills with the ability to juggle priorities and work under pressure to meet tight deadlines.
- Dedicated to meeting the expectations and requirements of internal and external customers, excellent at building effective relationships and gaining trust and respect.
- Fluency in foreign languages in addition to fluent English is a strong plus.
**About Cigna Healthcare**
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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._
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