Claims Representative

The Cigna Group

. Manually review and process medical, supplemental, or dental claims .

Posted 9/29/2026full-timeRemote • United StatesMid-LevelSenior💰 $18 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical claims processing, including validation of medical codes and assessment of claim eligibility. Proficient in using multiple computer applications and maintaining productivity in a virtual environment.

Highest-signal resume keywords

Medical Claims ProcessingCPT/ICD-10 Code KnowledgeMicrosoft Outlook ProficiencyDetail-OrientedOrganizational Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Claims ProcessingCPT CodesICD-10 CodesMicrosoft Excel FunctionsDocument ReviewClaims ValidationPolicy ApplicationInsurance TerminologyData AnalysisQuality Assurance

Soft Skills

Detail-OrientedStrong Organizational SkillsIndependent WorkProductivity FocusCollaboration

Tools & Technologies

Microsoft OutlookCisco WebexVirtual Collaboration ToolsComputer Applications

Industry Keywords

Health InsuranceClaims ProcessingSupplemental ClaimsDental ClaimsMedical Terminology

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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