C

Cigna Group

Sells health coverage and pharmacy benefits

Hospital Inspector

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeMadrid, SpainNo salary listed

About the Job

Requirements

  • A degree in Nursing is required.
  • At least 3 years of experience in an insurance company or a hospital administration or billing department is required.

Responsibilities

  • Control medical expenditure.
  • Optimize hospital stays.
  • Review hospital billing.
  • Improve the customer experience for admitted patients.
  • Monitor hospital census and follow up on hospital admissions.
  • Review and control hospital billing.
  • Improve Cigna customers’ experience using their insurance.
  • Support the call center with care-related guidance.
  • Refer patients to Case Management.
  • Control and manage medical expenditure for hospitals and healthcare professionals.
  • Control the service authorization, delivery, and billing process.
  • Detect fraud, waste, and abuse.
  • Design and implement cost-efficient procedures by specialty.
  • Manage hospital beds.
  • Negotiate with providers on annual rates and reconcile billing discrepancies.
  • Implement electronic provider billing.
  • Design and negotiate fee schedules for healthcare providers.

Desired Qualifications

  • Clinical hospital experience is valued.
  • A high level of English is desirable.

About the Company

Cigna Group

Sells health coverage and pharmacy benefits

The Cigna Group sells health coverage and pharmacy services to employers, health plans and individuals, and most of its business runs through Evernorth, its health services arm. Evernorth owns Express Scripts, one of the largest pharmacy benefit managers in the U.S., which negotiates drug prices and processes prescriptions for plan sponsors, plus the specialty pharmacy Accredo. Its Cigna Healthcare unit sells medical, dental and behavioral coverage, mostly to employers that fund their own plans, and earns premiums and administrative fees, while Evernorth earns service fees and drug margins. The company was formed in 1982 through the merger of Connecticut General and INA and is based in Bloomfield, Connecticut.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Bloomfield, CT
Founded
1982

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