Claims Representative

🔥 0 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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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

• Manually review and process medical, supplemental, or dental claims • Research and navigate documents and databases to accurately process claims in compliance with established guidelines • Confirm necessary documents are present in submitted claims • Validate medical codes in claim submissions • Assess claim eligibility based on established criteria • Review and verify other insurance coverage information • Evaluate authorizations for accuracy • Analyze account benefit plans to ensure claims align with coverage and policies • Identify discrepancies, errors, or missing information • Use multiple computer applications simultaneously • Meet or exceed quality and productivity goals • Work with supervisors, coaches, and trainers to learn efficient claims-processing techniques and workflows • Use Outlook, Cisco Webex, and similar virtual tools to collaborate and communicate with colleagues and supervisors • Complete responsibilities independently without close supervision

🎯 Requirements

• High school diploma or equivalent • Ability to quickly learn a variety of computer applications • Experience sending and receiving emails, scheduling calendar appointments, sending invitations, and attaching files in Microsoft Outlook • Knowledge of basic Microsoft Excel functions, including filtering and sorting • Experience navigating multiple computer applications using shortcut keys and other techniques • Detail-oriented with experience applying complex policy/procedure documents • Strong organizational skills and ability to prioritize tasks before deadlines • Proven experience completing work against quality and productivity performance standards • Experience working independently in a virtual environment preferred • Experience with medical and insurance terminology in a professional setting preferred • Knowledge of CPT/ICD-10 codes preferred • Proven experience in health insurance claims processing or a similar field preferred • If working from home, cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload

🏖️ Benefits

• Robust training program including virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements • Annual bonus plan eligibility • Medical benefits • Vision benefits • Dental benefits • 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