Claims Representative

The Cigna Group

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

Posted 9/30/2026full-timeRemote • Pennsylvania • United StatesMid-LevelSenior💰 $18 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in processing medical claims with a strong understanding of eligibility, benefits, and compliance. Proficient in utilizing various computer applications and tools to ensure accuracy and efficiency in claims processing.

Highest-signal resume keywords

Medical Claims ProcessingCPT/ICD-10 Code KnowledgeMicrosoft Excel FunctionsDetail-OrientedOrganizational Skills

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ReviewEligibility AssessmentDocument ValidationError IdentificationPolicy Application

Soft Skills

Strong Organizational SkillsDetail-OrientedAbility to Prioritize Tasks

Tools & Technologies

Microsoft OutlookCisco WebexComputer Applications

Industry Keywords

Medical TerminologyInsurance TerminologyHealth Insurance Claims

About the role

Key responsibilities & impact

Manually review and process medical, supplemental, or dental claims
Process claims according to benefits, eligibility, and internal processes, policies, and procedures
Complete, hold for additional information or review, or deny claims as appropriate
Research and navigate documents and databases to process claims accurately and compliantly
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, and missing information
Use multiple computer applications simultaneously
Meet or exceed quality and productivity goals
Work with supervisors, coaches, and trainers to improve processing techniques and workflows
Use Outlook, Cisco Webex, and similar virtual tools to collaborate and communicate with colleagues and supervisors
Complete a robust training program and meet accuracy, quality, volume, claims-per-hour, and production metrics after training

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 and 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 to 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
Cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload when working from home

Benefits

Comp & perks

Annual bonus plan eligibility
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
Robust training program including virtual classroom training, on-the-job learning, and feedback