Top 157 Claims advisor Jobs in North Carolina

Provider Contracting Advisor - Cigna Healthcare - Charlotte, NC (Hybrid)
The Cigna Group —Charlotte, NC
- Online Application
- Hybrid work
- Mid-level
- Bachelor's degree
- Mentoring
Personal Lines Insurance Agent
ALLCHOICE Insurance —Winston-Salem, NC
- $35,000 - $70,000 a year
- Full-time
- CRM software
- Mid-level
- Office
- 401(k)
- Paid time off
Quick Apply
Client Manager - Customer Service Representative
Highstreet Insurance & Financial Services – North Piedmont Branch —Windsor, NC
- $40,000 - $55,000 a year
- Full-time
- Spanish
- Customer service
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Patient Disability Advocate
Mission Health —Asheville, NC
- Full-time
- Remote
- Entry level
- Employee stock purchase plan
- Disability insurance
Quick Apply
2d
Risk Advisor - Commercial Lines
Towne Insurance —Raleigh, NC
- Hybrid work
- Mid-level
- Office
- Communication skills
- Profit sharing
- Paid training
Risk Advisor, Commercial Lines
Relation Insurance Services —Charlotte, NC
- $100,000 - $250,000 a year
- Full-time
- Microsoft Excel
- Computer literacy
- Mid-level
- Paid training
- Paid holidays
Employee Benefits Sales - Risk Advisor
Relation Insurance Services —North Carolina
- $100,000 - $250,000 a year
- Full-time
- Microsoft Excel
- Computer literacy
- Mid-level
- Paid holidays
- 401(k)
Senior Risk Management/Loss Control Consultant or Safety Professional (Remote in Raleigh or Greensboro, NC areas)
Amerisure Insurance —Charlotte, NC
- Full-time
- Hybrid work
- Clean driving record
- 5 years
- Microsoft Office
- Profit sharing
- Health insurance
Risk Advisor - Surety
Towne Insurance —Raleigh, NC
- Hybrid work
- Mid-level
- Office
- Communication skills
- Profit sharing
- Paid training
Patient Access Specialist
McKesson —Cary, NC
- $15.93 - $26.55 an hour
- Hybrid work
- Computer literacy
- HIPAA
- Office
- Prescription drug insurance
Commercial Lines, Account Manager (NC or remote)
NFP Corp —Charlotte, NC
- $60,000 - $95,000 a year
- Full-time
- Microsoft Word
- Microsoft Excel
- Mid-level
- Paid holidays
- Paid time off
Sr. Associate Analyst, Pharmacy Collections
McKesson —Cary, NC
- $24.83 - $41.39 an hour
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Research
Business Strategy Senior Advisor
Jack Henry —Charlotte, NC
- Full-time
- Remote
- PMP
- 8 years
- Analysis skills
Client Principal - AI Consulting (Property & Casualty Insurance)
CloudFactory —Raleigh, NC
- Full-time
- Remote
- Computer Science
- Analysis skills
- Continuous improvement
- Health insurance
- Dental insurance
Quick Apply
Technical Product Manager Advisor
Jack Henry —Charlotte, NC
- $107,700 - $155,000 a year
- Full-time
- Remote
- Data analysis skills
- Mid-level
- Bachelor's degree
8d
Claims Appraiser - Auto Estimatics
State Farm —Charlotte, NC
- $59,059.65 - $82,000.00 a year
- Overtime
- Mid-level
- Driver's License
- Clean MVR report
- Paid holidays
- Health insurance
4d
Employee Relations Partner - LOA
FUJIFILM —Holly Springs, NC
- Call employer
- 5 years
- Research
- Office
- Wellness program
- Health savings account
Business Analytics Senior Advisor - Clinical & Health Outcomes Research (Medical/Scientific Writing) - Hybrid
The Cigna Group —Raleigh, NC
- $112,800 - $188,000 a year
- Online Application
- 5 years
- Master's degree
- SQL
- Paid holidays
- Health insurance
Client Executive, Business Insurance
Marsh McLennan Agency —Charlotte, NC
- Full-time
- Hybrid work
- Bachelor's degree
- Experience equivalent to degree accepted
- Senior level
- Tuition reimbursement
Commercial Insurance Producer
The Misch Group —Charlotte, NC
- $90,000 - $175,000 a year
- Full-time
- Hybrid work
- Computer literacy
- Mid-level
- Bachelor's degree
Quick Apply
8d

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claims advisor jobs near north carolina

Provider Contracting Advisor - Cigna Healthcare - Charlotte, NC (Hybrid)

The Cigna Group -
Charlotte, NC

Apply Now

Job Details

Full-time

Benefits

Smoking cessation program

Qualifications

Term negotiation
Customer relationship building
Team leadership
Presentations for conferences or internal meetings
Contract interpretation
Client relationship development
Contract management experience in healthcare
Direct contracting
Customer engagement
Mentoring
Productivity software
Cross-functional communication

Full Job Description

Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Provider Contracting Advisor, you’ll report to the AVP, Provider Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management.

This is a hybrid role based in Charlotte, NC.

Responsibilities

Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
Build and maintain strong provider relationships to support network growth and value-based business opportunities.
Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.
Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
Work to meet unit cost targets while maintaining an adequate, competitive provider network.
Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms.
Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.

Required Qualifications

3-5 years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries
Background in managed care, healthcare, or health insurance, including commercial contracting
Proven leadership experience, including mentoring and guiding others
Strong provider relationship management skills and success developing long-term - partnerships
Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)
Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences
Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization
Customer-centric approach, strong interpersonal skills, and confidence in navigating change
Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills
Proficiency in Microsoft Office

Preferred Qualifications

Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA 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.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 need a reasonable accommodation to complete the online application process, please emailseeyourselfthecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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 mannerconsistent with all federal, state and local ordinances.

Apply Now

Refine Your Search

claims advisor jobs in north carolina

Provider Contracting Advisor - Cigna Healthcare - Charlotte, NC (Hybrid)

Personal Lines Insurance Agent

Client Manager - Customer Service Representative

Patient Disability Advocate

Risk Advisor - Commercial Lines

Risk Advisor, Commercial Lines

Employee Benefits Sales - Risk Advisor

Senior Risk Management/Loss Control Consultant or Safety Professional (Remote in Raleigh or Greensboro, NC areas)

Risk Advisor - Surety

Patient Access Specialist

Commercial Lines, Account Manager (NC or remote)

Sr. Associate Analyst, Pharmacy Collections

Business Strategy Senior Advisor

Client Principal - AI Consulting (Property & Casualty Insurance)

Technical Product Manager Advisor

Claims Appraiser - Auto Estimatics

Employee Relations Partner - LOA

Business Analytics Senior Advisor - Clinical & Health Outcomes Research (Medical/Scientific Writing) - Hybrid

Client Executive, Business Insurance

Commercial Insurance Producer

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