Claims Associate Representative

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $17 - $24 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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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

• Review, research, and process accounts receivable claims in a timely and accurate manner • Investigate denied, delayed, or underpaid claims, identify root causes, and take corrective actions • Communicate via outbound calls with third party payers, providers, and internal departments to resolve claim-related issues • Document all claim activity and maintain detailed records in compliance with organizational standards • Monitor claim status and follow up to ensure prompt resolution and payment • Escalate complex claims or unresolved issues to senior representatives or management when necessary • Maintain a strong understanding of payer policies, compliance requirements, and company procedures • Ensure complete review of outstanding balances related to claims • Demonstrate effective judgment when processing claims with outstanding balances

🎯 Requirements

• High school Diploma or GED • 2+ years of experience with medical claims handling and/or accounts receivable experience • 2+ years of experience with reconciliation, analytic skills, and the ability to interpret EOBs/EOPs, highly preferred • Proficient in Microsoft Office Products (Word, Outlook, Excel), required • Able to work both independently and collaboratively with a team, required • Highly oriented to detail, planning and organizing skills, required • Ability to work in a fast-paced environment, required • Time management and documentation skills • Ability to perform basic mathematics calculations, required • A high level of accuracy and attention to detail • For home working, internet service through a cable broadband or fiber optic provider with at least 10Mbps download/5Mbps upload

🏖️ Benefits

• Annual bonus plan eligibility • Medical, vision, and dental benefits starting on day one • Well-being and behavioral health programs starting on day one • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum of 18 days of paid time off per year • Paid holidays • Leaves of absence • Remote/home-based work option • Cable broadband or fiber optic internet requirement for home working

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