Remote Risk Adjustment Coding Jobs in Closter, NJ

Role Summary

The Eligibility Manager is a people leader responsible for overseeing complex chargeback, cash, and adjustment activities while ensuring operational excellence across the Chargeback Administration function. This role leads a team of 4-7 analysts, partners closely with leadership, vendors, and crossfunctional business partners, and drives efficiency, data quality, and resolution of escalated issues across chargeback and accounts receivable workflows.

This role includes direct people management and is accountable for coaching, developing, and prioritizing work across the analyst team. The Chargeback Manager reports to the Senior Manager and provides regular operational readouts, performance updates, and escalation insights to the Director to support decisionmaking, risk management, and strategic alignment.

Key Responsibilities

Operational & Analytical Responsibilities

• Lead day-to-day chargeback, cash application, and adjustment operations across a team of 4-7 analysts, ensuring workload balance, service levels, and quality standards are met
• Oversee advanced analysis and resolution of complex payment discrepancies, pricing variances, contractual issues, and aged receivable items
• Ensure accurate application of cash and adjustments in accordance with audit controls, contractual terms, and internal policies
• Prepare and review End-of-Month reporting, ad hoc analyses, and management-level summaries
• Monitor team performance, productivity, and operational metrics to identify risks and drive timely corrective action

People Leadership, Escalation & Vendor Support

• Directly manage, coach, and develop a team of 4-7 analysts, including performance management, prioritization, and capability building
• Serve as the primary escalation point for complex chargeback and accounts receivable issues, ensuring timely resolution and clear ownership
• Provide guidance and subject matter expertise to support accurate and timely resolution of chargeback activity across the team
• Partner with the Senior Manager on workload planning, team development, and operational priorities
• Provide regular readouts and escalation insights to the Director, highlighting performance trends, key risks, and recommended actions
• Act as a key liaison between Chargeback Operations, Finance, Pricing, and external vendors to resolve disputes and systemic issues

Vendor Management & Business Engagement

• Assist in establishing and maintaining regular business reviews / touchpoints with top vendors
• Prepare data, insights, and discussion materials for vendor touchpoints to drive accountability, transparency, and continuous improvement
• Track vendor performance trends, recurring issues, and followup actions resulting from business reviews
• Partner with internal stakeholders to align on vendor strategies, risks, and improvement opportunities

Process Improvement & Project Leadership

• Assist with spearheading projects focused on process efficiency, data cleanup, and operational improvements
• Identify gaps in current workflows, controls, or data quality and recommend sustainable solutions
• Partner with crossfunctional teams (Finance, Pricing, IT, Audit, Vendor Management) to implement process or system enhancements
• Document processes, controls, and best practices to support scalability and consistency across the team
• Support testing, validation, and adoption of system enhancements or process changes

Governance & Controls

• Ensure compliance with audit requirements, internal controls, and vendorspecific deadlines
• Contribute to risk identification and mitigation efforts related to chargeback processing and vendor performance
• Provide leadership with datadriven insights to inform prioritization and decisionmaking

Skills & Qualifications

• 5+ years of experience in chargebacks, accounts receivable, cash application, or adjustments within a B2B manufacturing or distribution environment
• Strong understanding of supplier contracts, chargeback processes, audit controls, and operational governance
• Demonstrated experience leading or managing teams, including coaching, performance management, and workload prioritization
• Advanced proficiency in Microsoft Excel, including complex formulas, pivot tables, and data analysis techniques
• Hands-on experience with ERP systems (SAP and/or Oracle required)
• Strong problem-solving skills with the ability to independently resolve issues and lead escalations across cross-functional stakeholders
• Excellent verbal and written communication skills, including experience engaging with vendors, leadership, and cross-functional partners
• Proven ability to manage multiple priorities, monitor team performance, and meet vendor-specific deadlines
• Experience preparing management readouts and operational summaries for senior leadership preferred

Education

• Associate's degree or higher preferred
• High school diploma or equivalency required

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 annual salary of 77,300 - 128,900 USD / yearly, 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.