Claims Processor

The Position:
We are looking for a detail-oriented claims processor to join our insurance
team. You will be responsible for preparing claim forms, verifying
information, and corresponding with agents and beneficiaries. You will also
handle client inquiries, review policies, determine coverage, calculate claim
amounts, and process payments.
To be successful as a claim’s processor, you should have excellent
organizational and interpersonal skills. You should also be able to work under
pressure and perform a range of clerical functions with great attention to
detail.
Main Duties / Responsibilities
A medical claims processor validates the information on all medical claims
from patients seeking payment from their insurance company.
Claims must be thoroughly reviewed to ensure that there is no missing or
incomplete information.
In addition, a processor must keep meticulous records of claims and follow up
on lapsed cases.
Medical claims processors are expected to have an extensive knowledge of
medical terminology, as well as experience using a computer.
Recording and maintaining insurance policy and claims information in a
database system.
Determining policy coverage and calculating claim amounts.
Processing claims payments.
Answering queries related to Policy coverage criteria and guidelines.
Complying with federal, state, and company regulations and policies.
Since medical claims processors must approve or deny payment to doctors, it is
vital that they know how to correctly read and assess medical documents.
Good communication skills are necessary to converse with doctors' offices or
insurance companies if there is a problem with the claim.
Performing other clerical tasks, as required.

Claims Processor Requirements:
Medical Qualification Background will be an added advantage.
At least ‎2 years of experience as a claim’s processor or in a related role.
Knowledge of Medical Terminologies, CPT codes and ICD-‎9 codes.
Working knowledge of the insurance industry and relevant federal and state
regulations.
Computer literate and proficient in MS Office.
Excellent critical thinking and decision-making skills.
Good administrative and organizational skills.
Strong customer service skills.
Ability to work under pressure.
High attention to details

About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better
health through every stage of life. We guide our customers through the health
care system, empowering them with the information and insight they need to
make the best choices for improving their health and vitality. Join us in
driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age,
disability, sex, childbirth (including pregnancy) or related medical
conditions including but not limited to lactation, sexual orientation, gender
identity or expression, veteran or military status, religion, national origin,
ancestry, marital or familial status, genetic information, status with regard
to public assistance, citizenship status or any other characteristic protected
by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application
process, please email: [email protected] for support. Do not email
[email protected] for an update on your application or to provide your
resume as you will not receive a response.