Provider Relations Associate Analyst - EviCore - Remote

Provider Relations Associate Analyst Summary: The Provider Relations Associate Analyst acts as a key liaison between EviCore's contracted provider network and internal teams. This role serves as the primary point of contact for provider and health plan inquiries, escalations, and operational issues. Success in this role requires a strong understanding of claims processing, contracting, credentialing, prior authorization workflows, and client-specific requirements. Key Responsibilities:

• Serve as the first line of support for contracted providers and health plans, addressing inquiries and resolving escalated issues.
• Facilitate communication between providers, health plans, and internal departments including operations, technology, and client services.
• Investigate and resolve operational issues related to claims, contracting, credentialing, eligibility, and complaints using defined processes and independent judgment.
• Ensure timely follow-up and resolution of provider concerns, maintaining clear documentation and communication throughout.
• Deliver high-quality service and ensure providers fully understand resolution outcomes and next steps.
• Navigate multiple internal platforms to access provider data, member information, authorizations, and claims.
• Support special projects through research, analysis, and ongoing maintenance to ensure operational efficiency and alignment with business and department goals.

Qualifications:

• Associate's degree or equivalent work experience required.
• Minimum of 2 years of experience in provider relations, client services, or healthcare operations.
• Strong working knowledge of claims processes is required.
• Proficiency in Microsoft Word and Excel (e.g., documentation, mail merges, data entry, spreadsheet creation).
• Experience with EMOS a plus
• Experience with ticketing or case management systems preferred.
• Must be able to work a full-time schedule (40 hours/week) within operating hours of 7:00 AM - 7:00 PM EST.

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 hourly rate of 20 - 30 USD / hourly, 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. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Apply tot his job Apply To this Job