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

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Manually review and process medical, supplemental, or dental claims • Research and navigate documents and databases to process claims accurately and in compliance with established guidelines • Confirm necessary documents are present in submitted claims • Validate medical codes in claim submissions • Assess claim eligibility • 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 • Complete work independently without close supervision • Meet or exceed quality and productivity goals • Work with supervisors, coaches, and trainers to improve claim-processing techniques and workflows • Use Outlook, Cisco Webex, and similar virtual tools to collaborate and communicate with colleagues and supervisors

🎯 Requirements

• High school diploma or equivalent • Ability to quickly learn various computer applications • Experience sending and receiving emails, scheduling calendar appointments and 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 experience applying complex policy and procedure documents • Strong organizational skills and ability to prioritize tasks before deadlines • Proven experience meeting 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 • Home internet connection through cable broadband or fiber optic 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