Claims & Provider Relations Advocate

The Cigna Group

. Answer inbound claim calls from members or providers, as well as contracting and Provider Relations calls from providers .

Posted 9/22/2026full-timeRemote • United StatesJunior💰 $24 - $37 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong customer service skills with a focus on problem-solving and effective communication. Proficient in managing claims processes and utilizing multiple claim systems to ensure accurate information delivery.

Highest-signal resume keywords

Customer Service ExperienceEligibility, Benefit, and EAP Call HandlingIndependent Problem-Solving SkillsEffective Listening and Organizational SkillsTechnical Capabilities with Claim Systems

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingAuthorization WritingClaim Status VerificationEOB Request ManagementTyping Proficiency

Soft Skills

Interpersonal Communication SkillsTime Management Skills

Tools & Technologies

Claim PlatformsEmail Communication

Industry Keywords

Billing ProtocolsProvider RelationsVirtual Team Environment

About the role

Key responsibilities & impact

Answer inbound claim calls from members or providers, as well as contracting and Provider Relations calls from providers
Spend the majority of the day answering calls from a queue in a structured work environment
Make occasional outbound calls to follow up on issues and resolve claim problems
Assist members or providers with understanding how claims have processed
Verify claim status
Educate members and providers on billing protocols
Write or correct authorizations to ensure claims are paid correctly
Send claims for adjustment or reprocessing across multiple claim platforms
Request duplicate EOBs
Request cancelled check copies, check reissues, or stop-pay/do-not-reissue actions
Send resources to members and providers by email
Submit complaints on behalf of members or providers
Send Advocate Handoff/Help Requests for escalated or complex issues
Assist providers with contract-related inquiries and demographic updates
Independently problem-solve to provide accurate information, exceptional customer service, and first-call resolution

Requirements

What you’ll need

Customer Service experience
At least 1 year experience taking Eligibility, Benefit, and EAP calls
Able to excel and/or prior successful experience in a virtual team environment
Ability to maintain a professional and positive image to members, providers, facilities, billing offices, etc.
Superb interpersonal communication skills
Effective listening and organizational skills, with the ability to manage multiple tasks
Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several claim systems and applications
Independent problem-solving skills
Strong time management skills
Ability to type effectively and have strong PC skills
Internet connection through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload when working at home

Benefits

Comp & perks

Annual bonus plan eligibility
Medical insurance
Vision insurance
Dental insurance
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