Claims Representative at Cigna

Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the world. Within its international division, a dedicated unit - headquartered in Belgium - focuses on the needs of International...

 

Claims Representative

  • Job TypeFull Time
  • QualificationBA/BSc/HND , Diploma
  • Experience1 year
  • LocationNairobi
  • Job FieldInsurance 

Main Duties / Responsibilities

  • A medical claims processor validates the information on all medical claims from patients seeking payment from the 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:

  • A medical-related Diploma or Degree qualification is required.
  • At least 1 year as a medical claims processor.
  • Familiarity with medical terminologies and understanding of 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.

Check how your CV aligns with this job

Method of Application

Interested and qualified? Go to Cigna on cigna.wd5.myworkdayjobs.com to apply

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