Title: Appeals Processing Senior Representative - Evernoth - Remote Location: Remote Category: Medical & Pharmacy Job Id26004794 Job Description: - Position Summary The Clinical Coder conducts outpatient post-service administrative claims or appeals coverage determinations (such as bundling reviews) for which they are empowered outside of our company's clinical unit manager program requirements. This role applies all benefit plan limitations or exclusions and applicable federal and state regulatory requirements to each case review, including Patient Protection and Affordable Care Act. The Clinical Coder also keeps all HIPAA regulatory requirements. This role is for a Medical Coder; not Appeals Processing. - Responsibilities - Makes coverage determinations only on retrospective administrative OP claims/appeals such as bundling reviews using standard NAO and claims policies and procedures and company administrative guidelines. - Research claims and appeals information, submitted review request letters or referrals and related materials in order to make coverage determinations on retrospective OP claims/appeals such as bundling reviews. - Accurately screens any claim referral or appeal subject to state or federal mandates in order to correctly make coverage determinations on retrospective administrative outpatient claims/appeals such as bundling. - Confirms appeal set up to meet state regulatory requirements on non-ASO appeals. - Communicates approval or denial determinations made on retrospective administrative outpatient claims/appeals such as bundling reviews as required. - Documents all retrospective administrative OP claims/appeals such as bundling reviews in the appropriate unit manager and appeals/calls systems as directed by the National Appeals Organization (NAO) policies and procedures. - Manages assigned workload to completion within timeliness metrics as set forth by ERISA, state mandates, PPACA, NCQA and URAC. - Completes all required training per regulatory and credentialing body standards. - When requesting protected health information (PHI) from external or internal sources, employee limits requests for information to reasonably necessary information required to accomplish the intended purpose; accesses the minimum necessary amount of protected health information (PHI) needed to perform job functions; limits the health information disclosed to the amount reasonably necessary for its intended purpose on all routine or recurring disclosures of protected health information (PHI). Qualifications - High school education or GED required. - Required coder certification; only accepted for 2 programs: AAPC (American Academy of Professional Coders): CPC (Certified Professional Coder) or AHIMA (American Health Information Management Association): CCS-P (Certified Coding Specialists-Physician based). Note: Apprentice stage of certification is not eligible. - 1 + year experience CPT-4 and ICD-9/ICD-10 coding experience preferred. - Familiarity with state and federal regulations preferred. - Greater than 2 years’ experience in billing, claims, customer service, or health insurance preferred. - Good research and analytic skills per employee work history. - Proven ability to work independently. - Demonstrated good judgment. - Proven detail orientation - Strong organizational skills - Strong knowledge in medical terminology, anatomy and physiology. 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 19 - 29 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. At The Cigna Group, 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), 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, click here. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 email seeyourself@thecignagroup.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 manner consistent with all federal, state and local ordinances.

Title: Business Development Director Location: USA FL Tampa Hybrid Full Part/Time: Full time Job Req: RQ218310 Type of Requisition: Regular Clearance Level Must Currently Possess: Top Secret Clearance Level Must Be Able to Obtain: Top Secret Public Trust/Other Required: None Job Family: Business Development Job Qualifications: Skills: Communication, Government Contracts, Leadership Certifications: None Experience: 5 + years of related experience US Citizenship Required: Yes Job Description: BUSINESS DEVELOPMENT DIRECTOR Own your opportunity to work with the largest government agency in the nation. Make an impact by advancing the Department of War's mission to keep our country safe and secure. OUR COMPANY Iron EagleX (IEX), a wholly owned subsidiary of General Dynamics Information Technology (GDIT), delivers agile IT and Intelligence solutions. Combining small-team flexibility with global scale, IEX leverages emerging technologies to provide innovative, user-focused solutions that empower organizations and end users to operate smarter, faster, and more securely in dynamic environments. JOB DESCRIPTION As the Business Development Director, you will lead strategic growth initiatives across federal markets, driving capture and expansion efforts for high-value contracts. This role requires a proven leader with deep knowledge of federal procurement, capture management, and government customer engagement across civilian, defense, and/or intelligence sectors. You will shape market strategy and drive the full business development lifecycle for complex programs. JOB DUTIES (INCLUDE BUT ARE NOT LIMITED TO) - Develop integrated pipeline of opportunities with the Business Development/Growth Leader. - Assess progress in assigned projects/programs including cost estimates, schedules, and performance supportability baseline requirements by applying known methods and procedures. - Help establish management controls such as milestones, expenditure rates, management indicators, and management reviews to reflect program status and provide early detection of emerging problems. - Assist in providing feedback to customers and keep abreast of changing environments and potential shifts in emphasis or other program changes. - Visit Government personnel to help observe progress, discuss and resolve problems, and otherwise ensure the contractor is meeting contractual provisions and is prepared for future opportunities. - Conduct presentations and demonstrations on pipeline management, program status, costs, adherence to baselines and schedules. - Analyze interrelated issues of effectiveness, efficiency, and productivity; develop recommendations to solve problems. - Responsible for the overall management of the BD effort in identifying opportunities for sales growth and profit enhancement in GDIT's Defense sector - Plans and recommends business and marketing strategies to achieve maximum penetration consistent with Company financial objectives. - Leads and manages BD business operations (e,g, Capture Planning Process, Bid and Proposal Process, policy development and enforcement) - Prepares customer and strategic presentations including the annual and strategic marketing plan REQUIRED SKILLS: - Clearance: Current DoW Top Secret Clearance is required with ability to obtain TS/SCI. - Experience: 5+ of progressive experience in business development within the federal contracting space. - Multiple years' experience, managing teams of people responsible for writing, winning and executing programs across multiple customers around the world. WHAT YOU'LL NEED TO SUCCEED - Expertise in Defense and Intelligence markets - Proven success leading multi-million or billion-dollar capture efforts for federal customers. - Demonstrated history of strategic relationship-building and sustained revenue growth. - Strong leadership, communication, and negotiation skills. - Role requirements: Hybrid work environment with 3 days on site in Tampa and two days' WFH - Due to US Government Contract Requirements, only US Citizens are eligible for this role The likely salary range for this position is $170,144 - $224,250. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range. Scheduled Weekly Hours: 40 Travel Required: 10-25% Telecommuting Options: Hybrid Work Location: USA FL Tampa - 2701 N Rocky Point Dr, Suite 1150 (FLS026) Additional Work Locations: Total Rewards at GDIT: Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most. We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

• Represents the Facial Aesthetics product portfolio to targeted aesthetic customers within a designated geographical area • Responsible for creating product acceptance and enhancing portfolio growth through business development activities • Provides technical product and procedure expertise as well as competitive product differentiation • Assigned sales goals are obtained through creative, consultative selling and implementation of the U.S. Sales/Marketing plan • Leverages resources to accelerate the adoption and sales growth of the Facial Aesthetics portfolio • Works and coordinates activities with other Allergan Aesthetics cross portfolio partners and support teams • Complies with required reporting, requests, and compliance policies

• The Business Development Manager, MENA will be the core driver behind the company’s growth strategy through new and existing partners and Business Development Managers in Turkey. • A professional who can identify and build strong, lasting strategic relationships with new and existing partners. • Execute the company’s growth strategy based on Introducing Brokers, Strategic Partners and BDMs in Turkey to increase revenue and expand our regional footprint. • Lead expansion in new markets within Turkey by building new strategic partnerships in the region and leverage existing and past partner relationships. • Proactively identify opportunities to improve current processes across functional areas, optimizing our procedures for efficiency and productivity.