[Remote/WFM] Claims Representative Full-Time - Remote Jobs

Join our friendly team! We have a simple and rewarding job for a Claims Representative Full-time - Remote! An immediate start is available for this Remote-based position, which places you at the center of innovation. This position requires a strong and diverse skillset in relevant areas to drive success. This role offers a salary package of a competitive salary, commensurate with experience.

 

 

We’re looking for detail-oriented and self-disciplined individuals to join our team as Claims Representatives. In this role, you’ll be responsible for accurately reviewing and processing medical, supplemental, or dental claims. You’ll analyze submitted documents, validate data, and ensure compliance with company policies and benefit plans. This position includes robust training to set you up for success, including virtual classroom sessions and hands-on learning. Over time, you’ll gradually take on increased claims volume and quality requirements. Responsibilities: • Review and process claims in accordance with established policies and benefit plans. • Research and verify documents, medical codes, and eligibility criteria in claim submissions. • Analyze account benefit plans to ensure accuracy and compliance. • Identify and resolve discrepancies, missing information, or errors in claims. • Utilize multiple computer applications and virtual tools to complete tasks and collaborate with colleagues. • Maintain productivity and quality standards while working independently. • Engage in ongoing training to enhance skills and processing efficiency. • Meet deadlines and performance metrics, including claims per hour and accuracy goals. Qualifications: • Required: • High school diploma or equivalent. • Proficiency with Microsoft Office Suite, including Outlook and Excel (e.g., filtering/sorting data). • Experience navigating and multitasking across various computer applications. • Strong organizational skills, attention to detail, and the ability to prioritize tasks. • Proven ability to work independently and maintain productivity in a remote setting. • Reliable high-speed internet connection: Minimum 10Mbps download/5Mbps upload (cable broadband or fiber optic). • Preferred: • Experience with medical/insurance terminology and claims processing. • Familiarity with CPT/ICD-10 codes. • Previous health insurance claims experience or similar professional background. Compensation and Benefits: • Hourly pay: $17 - $25, based on experience and location. • Annual bonus eligibility. • Comprehensive health benefits (medical, vision, dental, behavioral health) starting on day one. • Additional benefits: • 401(k) with company match. • Company-paid life insurance. • Tuition reimbursement. • 18+ days of paid time off annually, plus paid holidays. For more details, visit Life at The Cigna Group. About Us: At The Cigna Group, we’re committed to improving lives and health outcomes. Through our divisions—Cigna Healthcare and Evernorth Health Services—we deliver meaningful services that make a difference in the lives of our clients and customers. We value diversity and are committed to creating an inclusive workplace. Qualified applicants will be considered without regard to race, color, age, disability, sex, sexual orientation, gender identity, veteran status, religion, national origin, or other protected characteristics. Tobacco-Free Hiring Policy: In certain states, The Cigna Group reserves the right not to hire tobacco/nicotine users unless they participate in a cessation program before their employment start date. Apply Job!

 

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