Claims Senior Representative at Cigna

YOUR RESPONSIBILITIES

Claims Management

Manage end-to-end medical claims processing, ensuring accurate adjudication, timely turnaround, and resolution in line with policy terms and SLA requirements.

Team Training & Mentorship
Provide coaching, training, and ongoing guidance to claims handlers, particularly on complex cases, to drive accuracy, productivity, and overall team performance.

Customer & Stakeholder Engagement
Act as a subject matter expert for clients and internal stakeholders, addressing escalations, providing claim updates, and ensuring a high level of service delivery.

Cross-functional Collaboration
Partner closely with internal teams and other books of business to resolve claims efficiently and improve overall operational effectiveness. Compliance &

Governance
Ensure all claims are processed in accordance with regulatory requirements, company policies, and internal quality standards, maintaining high audit and compliance scores.

Process Improvement & Strategy
Identify gaps and drive continuous improvement initiatives in claims processes, workflows, and customer experience.

Additional Responsibilities:

Negotiation & Resolution
Support negotiations with stakeholders to achieve fair and accurate claim outcomes, particularly for complex or high-value cases. Reporting & Analysis
Prepare and analyze claims reports, identify trends, and provide insights to support operational decision-making and performance improvement.

REQUIREMENTS:

• Minimum 3 years of experience in medical claims processing / insurance operations
• Strong understanding of medical claims lifecycle, adjudication, and policy coverage
• High attention to detail with strong accuracy and quality focus
• Good communication and stakeholder management skills
• Experience in training, mentoring, or supporting junior team members is an advantage
• Ability to manage multiple priorities in a fast-paced environment

About The Cigna Group