Job description
Role Overview
Contract Associate Analyst at Cigna. The role focuses on validation and compliance of CHI (Central Health Information) uploads, ensuring accurate member data and regulatory adherence.
Company Overview
The Cigna Group is dedicated to improving the health and vitality of those it serves. Through divisions Cigna Healthcare and Evernorth Health Services, the organization is committed to enhancing the lives of clients, customers, and patients.
Role Purpose
Own the validation and compliance of CHI uploads by verifying policy and member data accuracy, investigating mismatches, processing corrections within SLA timelines, and ensuring all uploads meet regulatory requirements and internal standards.
Key Responsibilities
Data Verification & Validation
- Verify policy and member mandatory information before uploading onto CHI.
- Ensure National ID, Iqama, Border Number, Passport Number, and Member IDs are accurate and match supporting documents.
- Perform pre-upload validation on additions, deletions, transfers, and corrections to prevent CHI rejections.
- Confirm policy effective dates, enrollment dates, and renewal dates align with underwriting approval and policy setup.
Investigation & Issue Resolution
- Investigate mismatches between client census files, system records, and CHI requirements.
- Analyze rejection reasons, coordinate corrections, and resubmit records within agreed SLA timelines.
- Track uploaded members until successfully accepted and linked in the CHI portal and escalate unresolved cases promptly.
Data Processing
- Process updates such as DOB corrections, ID changes, relationship changes, and member transfers between groups.
Compliance & Reporting
- Ensure all uploads meet regulatory requirements and internal compliance standards.
- Produce validation error reports, rejection analysis, SLA performance reports, and recommendations to reduce upload failures and improve first-time-right quality.
- Ensure validation mailbox is reviewed and actioned within SLA.
Qualifications & Experience
- Bachelor's degree in healthcare administration, Business, or related field (or equivalent work experience).
- 1 to 2 years of experience in benefit setup or insurance policy administration within a health insurance company.
- Experience with benefit configuration tools and administrative platforms.
- Familiarity with medical coverages and CHI uploads, eligibility process.
- Knowledge of insurance regulatory requirements (CHI, IA, Nphies).
Skills & Competencies
- Excellent attention to detail and analytical skills.
- Proficient in MS Office (Excel, Word) and data entry systems.
Additional Information
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 SeeYourselfEMEA@cigna.com for support.