Claims Officer - Cigna Healthcare
Core
Assess member reimbursement and provider claims accurately by reviewing medical information, policy benefits, and supporting documentation to ensure fair and consistent claim assessments.
Role type
Claims Associate Analyst (Health Insurance)
Builds
Medical reimbursement and provider claims decisions
Domain
Health Insurance / Middle East
Required skills
Medical degree (BDS, MBBS, BAMS, BHMS, Nursing, or allied health), Medical terminology knowledge, ICD/CPT coding basics, Health insurance benefits understanding, Analytical skills, Attention to detail
Preferred skills
1-2 years experience in medical claims/preauthorization, International/Middle East claims experience, Claims processing systems proficiency
Technologies
Microsoft Office, Claims processing systems
Responsibilities
Assess member reimbursement and provider claims accurately, Review claim forms and supporting documentation, Validate member eligibility and coverage details, Apply policy terms and clinical guidelines, Identify billing inconsistencies and non-covered services, Maintain auditable notes for claim decisions, Request additional information and escalate complex cases
Seniority
Entry to Junior, hands-on IC