Issue Resolution Lead Analyst, Individual Dental Operations

Job not on LinkedIn

🔥 1 minute ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $62.6k - $104.3k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• Manage customer issue intake queues by tracking, prioritizing, researching, documenting, resolving, and closing cases • Research and resolve complex or sensitive customer issues, complaints, Senior Leadership inquiries, and Department of Insurance matters • Support inquiries received through federal exchange and state-based marketplace channels • Evaluate customer needs and develop effective resolutions using technical knowledge and established processes • Communicate findings, decisions, and resolutions to customers, business partners, and leadership • Maintain complete and accurate case documentation • Monitor case activity and turnaround times for regulatory and internal compliance • Identify and escalate compliance risks, missed dependencies, and resolution barriers • Protect customer information and follow privacy, security, documentation, and records-management requirements • Support audits, compliance reviews, and operational inquiries • Analyze issues and case activity to identify recurring themes, trends, process gaps, and risks • Recommend improvements to customer service processes, workflows, controls, communications, and documentation • Participate in operational projects, business testing, and process-improvement initiatives • Provide technical guidance and subject matter expertise to team members and cross-functional partners • Coordinate timely resolutions with Operations, Compliance, Customer Service, and business support teams • Share trends, risks, and lessons learned • Independently manage workload, competing priorities, and time-sensitive requests

🎯 Requirements

• Minimum of three years of healthcare insurance business experience in benefits, eligibility, claims, customer service, contact center operations, sales, or business operations • Minimum of two years of experience handling complex Stand-Alone Dental customer inquiries • Current experience within IFP, including marketplace operations, regulatory requirements, and customer issue resolution processes • Understanding of federal exchange and state-based marketplace environments • Knowledge of customer issue research, case management, escalation handling, and documentation requirements • Ability to manage multiple priorities, meet tight deadlines, and adjust to changing business needs • Strong analytical, decision-making, and problem-solving skills • Ability to apply technical knowledge, business processes, and available resources to drive accurate and timely resolution • Strong verbal and written communication skills • Proficiency with Microsoft Office applications and internal systems used to support IFP and Dental operations • Ability to work additional hours and adjust planned time off during peak operating periods • Preferred: Experience handling Senior Leadership escalations, Health Insurance Casework System matters, or Department of Insurance casework • Preferred: Experience with IFP Dental products, systems, and processes, including Dentacom, Dentaque, OneView, and applicable claim-processing guidelines • Preferred: Experience supporting operational testing, trend analysis, process improvement, or business documentation • Preferred: Experience providing technical guidance, peer support, or informal leadership within an operational team • For home work, cable broadband or fiber optic internet service with at least 10Mbps download and 5Mbps upload

🏖️ Benefits

• Annual bonus plan eligibility • Medical insurance • Vision insurance • Dental insurance • Well-being and behavioral health programs • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays • Leaves of absence • Remote work arrangement (occasionally or permanently, subject to internet requirements)