Medical Review Technician

The Cigna Group

. Coordinate and collaborate in the medical review process .

Posted 10/16/2026full-timeRemote • Montana • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates proficiency in medical terminology and coding, ensuring accurate documentation and compliance with privacy standards. Capable of effectively coordinating medical reviews and managing communications with providers and external review companies.

Highest-signal resume keywords

Medical TerminologyCPT CodingICD CodingClaims Processing SoftwareCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical CodingCPT CodesICD CodesClaims ProcessingData EntryQuality ControlMathematical SkillsOffice Equipment OperationDocumentationBenefit Analysis

Soft Skills

Excellent CommunicationInterpersonal SkillsOrganizational SkillsProblem-SolvingAdaptability

Tools & Technologies

Care Management PlatformWindowsMicrosoft WordInternet Connection

Certifications & Qualifications

High School GraduationGED

Industry Keywords

Medical Review ProcessHealth Insurance ConceptsPrivacy StandardsPeer-to-Peer RequestsReferral Management

About the role

Key responsibilities & impact

Coordinate and collaborate in the medical review process
Provide courteous and prompt preparation and responses for referrals
Manage daily work assignments
Assist in managing incoming faxes
Coordinate receipt and entry of pretreatments and/or pre-certification requests
Ensure accurate coding using CPT and ICD codes
Communicate with attending/servicing providers to obtain complete and accurate information
Upload and monitor external reviews sent to external review companies
Correspond with external review companies as necessary
Perform quality controls on review responses for accuracy and completeness
Process review determinations accurately within required timeframes
Coordinate with the clinical team as necessary
Document accurately and timely in the Care Management Platform
Facilitate and schedule peer-to-peer requests
Review member account accuracy in the Care Management platform and report as necessary
Initiate referrals for Case Management when appropriate
Participate in team meetings, committees, or committee assignments
Receive and relay communications to appropriate parties in a timely manner
Contribute to daily workflow with regular and punctual attendance

Requirements

What you’ll need

High school graduation or GED required
Medical terminology and medical coding experience preferred
Excellent oral and written communication skills
PC skills, including Windows and Word
Ability to learn and adapt to claims processing software changes
Knowledge of medical terminology and basic health insurance concepts
Excellent listening skills
High interpersonal skills to work effectively with others
Ability to organize and recall large amounts of detailed information
Ability to read, analyze and interpret benefit summary plan descriptions, insurance documents, plan benefits, and regulations and apply them to specific situations
Ability to identify errors/oversights and make corrections
Ability to project a professional image and positive attitude
Ability to comply with privacy and confidentiality standards
Ability to work flexibly under pressure and meet deadlines
Ability to analyze and solve problems, exercise good judgment, and make decisions professionally
Ability to operate typical office equipment
Working knowledge of general office procedures
Ability to meet standard deadlines and timelines for appeals and reviews
Basic mathematical skills
Required internet connection through cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload when working from home

Benefits

Comp & perks

Remote work arrangement
Work-from-home internet service requirement supported by cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload
Tobacco-free policy
Reasonable accommodation assistance for the online application process