Claims Representative

The Cigna Group

Remote Claims Representative processing medical, supplemental, and dental claims for The Cigna Group. Reviewing eligibility, codes, benefits, authorizations, and documentation for accurate adjudication.

Posted 8/10/2026full-timeRemote • Tennessee • 🇺🇸 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 CPT/ICD-10 codes and health insurance terminology. Proficient in using multiple computer applications and maintaining high-quality standards in a virtual environment.

Highest-signal resume keywords

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Claims ProcessingCPT/ICD-10 Code KnowledgeDetail-OrientedMicrosoft Excel FunctionsHealth Insurance Terminology

Soft Skills

Strong Organizational SkillsAbility to Work Independently

Tools & Technologies

Microsoft OutlookCisco WebexMultiple Computer Applications

Industry Keywords

Health InsuranceClaims ProcessingMedical TerminologySupplemental ClaimsDental Claims

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 in compliance 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
Complete work independently without close supervision
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 various computer applications
Experience sending and receiving emails, scheduling calendar appointments and invitations, and attaching files in Microsoft Outlook
Knowledge of basic Microsoft Excel functions, including filtering and sorting
Experience navigating multiple computer applications using shortcut keys and other techniques
Detail-oriented experience applying complex policy and procedure documents
Strong organizational skills and ability to prioritize tasks before deadlines
Proven experience meeting 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
Home internet connection through cable broadband or fiber optic service with at least 10 Mbps download and 5 Mbps upload

Benefits

Comp & perks

Robust training program including virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements
Annual bonus plan eligibility
Medical benefits
Vision benefits
Dental benefits
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