Client Account Support Lead Analyst - Express Scripts - Remote

DESCRIPTION:

As a Client Account Support Lead Analyst on the PBM Operations (Client Service Delivery) Adjustments team, you will work directly with account teams and finance analysts to correct claims that processed incorrectly due to benefit setup issues, resulting in system-generated member and/or client refunds

ESSENTIAL FUNCTIONS:

• Partner with account teams to understand the scope/range of prescription claims that are potentially impacted by a setup error
• Using a repricing tool, submit claims to be re-adjudicated systematically against a corrected benefit setup
• Collaborate with account teams and finance analysts to review output from the reprice tool to determine if claims are now processing as intended
• Work with a finance analyst to uploaded "corrected" claims into the Information Warehouse
• Address complex adjustment scenarios with strategic mindset

QUALIFICATIONS:

• High School diploma required.
• 5 plus years of professional experience preferred.
• 3 plus years with pharmacy benefits knowledge preferred.
• Understanding of the basic components of benefit design (e.g., copays, coinsurance, deductibles, etc.) required.
• Strong analytical and communication skills, and an ability to collaborate with account teams and finance partners preferred.
• Strong working knowledge of MS Excel required.
• Bachelors' degree preferred.
• Relevant work experience in the pharmacy benefits management space preferred.

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 59,500 - 99,100 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.

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 Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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: [email protected] for support. Do not email [email protected] 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.