Intake Care Associate Analyst

About the role

Cigna Healthcare is hiring an Intake Care Associate Analyst who manages the full continuum of care management and cost containment, from pre-service authorization through post-service claims review and provider negotiations. The role ensures clinical appropriateness, policy compliance and cost-effective care, and coordinates services for complex and high-risk members. It operates on a 24/7 schedule, with selected candidates assigned to one of three shifts (8pm-6am, 9pm-7am or 7am-3pm EAT) and requires flexibility to work weekends and holidays.

Key responsibilities

• Review and process preauthorization requests for medical services, procedures and treatments, assessing medical necessity against clinical guidelines, policy criteria and regulatory requirements
• Collaborate with clinical teams to ensure the appropriate level of care and service utilization
• Identify high-risk or high-cost cases early and route them to care coordination or case management
• Review medical claims for accuracy, coding integrity and benefit alignment, and flag billing discrepancies, overutilization and cost-saving opportunities
• Support appeals, reconsiderations and audits, and analyze trends in high-cost claims to recommend process improvements
• Negotiate out-of-network claims, high-cost procedures and single-case assignments, working with provider network and contracting teams
• Document and track savings outcomes, and partner with case management, clinical teams and providers to ensure continuity and quality of care

Required profile

• Degree or diploma; additional education in healthcare, business or related fields preferred
• Excellent written and oral communication skills and a good telephone manner
• Flexibility and ability to multi-task, with a high level of accuracy and attention to detail
• Problem-solving and decision-making abilities, teamwork, and the ability to interpret data and identify trends

Required skills

• Knowledge of medical claims adjudication, prior authorization, medical necessity review and utilization management guidelines
• Ability to review clinical documentation and apply coverage criteria
• Coding certification (e.g. CPC, CCS) is a plus but not required