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Eligibility Lead Analyst at Cigna

Posted in General Business 10 days ago.

Type: Full-Time
Location: Bethlehem, Pennsylvania

Job Description:

The Eligibility Lead Analyst is responsible for managing the implementation of Electronic Data Interchange (EDI) to support eligibility services of Supplemental Health Products, Accidental Injury, Critical Illness, and Hospital Care. Regularly works with client, vendor and Cigna business partners to project manage EDI implementation to meet client effective date. Must be able to lead conference calls to discuss file requirements with client and vendors as it relates to the specific type of feed: enrollment, eligibility, billing, etc. Educate Cigna standards layout, data requirements and electronic data transmission connection base on the client's needs. Provide consultative solutions on programming logic to meet file specification requirements. Manage interfaces in coherence with project plan. Work with internal partners IT, eCommerce, Voluntary Product Operations to map and process files. Define requirements and drive accountability regarding deadlines. Provide a positive client experience to our clients and vendors and ensure that implementation is completed to meet effective date.


• Implement all file feed interfaces based on established timelines.

• Articulate programming logic to IT on file mapping and merging requirements.

• Review and audit test file and provide appropriate feedback to client and vendor to ensure quality data is implemented.

• Provide file feed consultative solutions to our clients and internal business partners on receiving eligibility data

• Trouble-shoot and diagnose issues related to electronic data being exchanged by our clients.

Integrate with TPAs in support of eligibility/enrollment data for template certification.

• Develop and maintain documentation on internal process and training materials.

• Partner with eCommerce and IT to ensure successful receipt and processing of data.

• Manage maintenance file activities and support team mailbox inquiries.

• Track case status in Enterprise Operation Tools and Database to ensure metrics are being reported accurately.

• Macro and Vlook up tool development for process improvement.

• Lead Supplemental Health Solution initiative project as subject matter expert


• Bachelor's Degree is required

• Minimum of 3 years work experience in Electronic Data Interchange (EDI) or similar is preferred.

• Prior experience working with clients, producers, and/or TPA's preferred.

• Strong analytical, problem-solving and detailed oriented skills required.

• Strong planning and project management skills preferred.

• Demonstrated experience in Microsoft Excel (including vlook up, pivot table, and macro) is required.

• Access experience is preferred

• Excellent organization skills to be able to multi-task and meet increasingly tight deadlines required.

• Excellent written and verbal communication skills required.

• Strong interpersonal skills required.

• Demonstrated ability to drive results required.

• Have the ability to work independently and collaborate with internal business partners required.

• Demonstrated leadership and motivational skills in fast-paced environment.

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 52,700 - 87,800 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 .

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.

Cigna 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.

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