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The Cigna Group
The Cigna Group
HealthcareHealthcare InsurancePharmaceuticals
The Cigna Group is a global healthcare company operating through Cigna Healthcare and Evernorth Health Services. Its work combines healthcare services, health insurance, and pharmacy benefits management to support the health and wellbeing of customers, clients, and patients. The company also focuses on ethical healthcare and artificial intelligence practices, health equity, responsible environmental and social governance, and innovation in how care is delivered.
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Remote Supplemental Health Claims Representative

The Cigna Group is hiring a full-time remote Claims Representative to process Supplemental Health claims in the United States. The role evaluates eligibility, medical codes, coverage, authorizations, and benefit provisions while maintaining accurate, compliant claim decisions.

USUnited States
$17 – $26 / hour
RemoteFull-timeMiddleSeniorEnglish RequiredClaims Specialist
Cognos

Description

  • Process Supplemental Health claims accurately and within required timelines
  • Review claim submissions and verify that required documentation is complete
  • Validate medical codes, eligibility, coverage, other insurance, authorizations, and benefit plans
  • Interpret policy provisions to determine benefit eligibility
  • Pay, pend for more information, or deny claims in line with established policies and procedures
  • Monitor pending claims and communicate claim decisions
  • Achieve or exceed defined quality, productivity, performance, and KPI targets
  • Join virtual team huddles, supervisor meetings, and check-ins through Outlook, Microsoft Teams, Cisco Webex, and comparable tools
  • Protect accuracy and confidentiality while meeting regulatory compliance requirements
  • Work across multiple computer applications at the same time
  • Detect discrepancies, errors, and missing information
  • Use eMOS tools—including DPL, Performance Profile, Ring Master, SAM3, and other reporting systems—to maintain production and quality standards
  • Coordinate with the Resource Management Group on Workflow Tool activities, COGNOS pending reports, and inventory matters
  • Collaborate with supervisors, coaches, and trainers to refine claim-processing methods and workflows
  • Work independently in a virtual setting with accountability, professionalism, and effective time management

Requirements

  • High school diploma or equivalent
  • Strong attention to detail and problem-solving ability, with a high degree of accuracy
  • Ability to work across multiple computer applications using shortcut keys and other techniques
  • Proficiency with Microsoft Office applications, including Word, Excel, Outlook, OneNote, and PowerPoint
  • Knowledge of medical and insurance terminology, including CPT and ICD-10 codes
  • Previous health insurance claims processing or related experience preferred
  • Excellent organizational, interpersonal, written, and verbal communication skills
  • Strong organizational ability and capacity to prioritize work against deadlines
  • Experience providing exceptional customer service
  • Ability to work comfortably in a fast-paced, deadline-driven environment
  • Ability to type and use a keyboard for extended periods
  • Integrity and personal accountability for performance and job expectations
  • Ability to interpret policy language and apply complex benefit provisions
  • Cable broadband or fiber optic internet service providing at least 10 Mbps download and 5 Mbps upload speeds for home working

Benefits

  • Eligibility for an annual bonus plan
  • Medical insurance
  • Vision insurance
  • Dental insurance
  • Well-being and behavioral health programs
  • 401(k) plan
  • Company-paid life insurance
  • Tuition reimbursement
  • At least 18 days of paid time off per year
  • Paid holidays
  • Leaves of absence
  • Structured training with virtual classroom instruction and on-the-job coaching
  • Remote work from home
  • Cable broadband or fiber optic internet service providing at least 10 Mbps download and 5 Mbps upload speeds

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