Claims Representative

🔥 0 minutes ago

🌵 Arizona, Connecticut, +5 more states – Remote

🌵 Arizona – Remote 🦌 Connecticut – Remote 🌽 Illinois – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🔔 Pennsylvania – Remote 🎸 Tennessee – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 comply 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 • Work independently without close supervision while maintaining productivity and quality • 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 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, such as filtering and sorting • Experience navigating multiple computer applications using shortcut keys and other techniques • Detail-oriented with experience applying complex policy and procedure documents • Strong organizational skills and ability to prioritize tasks before deadlines • Proven experience completing work with 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 similar field preferred • Home internet connection through cable broadband or fiber optic service with at least 10 Mbps download and 5 Mbps upload

🏖️ Benefits

• Medical, vision, and dental benefits starting on day one • 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 • Annual bonus plan eligibility • Robust training program including virtual classroom training, on-the-job learning, and feedback