Claims Representative - Evernorth - Remote

Job Description

Responsibilities:

• Review claim images to determine accurate routing and handling.
• Search member information in Cigna systems and update database fields to route items to correspondence or appeals.
• Follow established policies and procedures to support accurate processing and automation.
• Use multiple computer applications simultaneously and navigate systems efficiently.
• Maintain accuracy by identifying discrepancies, errors, or missing information.
• Meet or exceed quality, production, and Key Performance Indicator (KPI) expectations.

New advocates complete a comprehensive training program that includes virtual classroom instruction, on-the-job learning, feedback, and gradually increasing productivity and quality expectations. After training, advocates are expected to meet established accuracy, volume, and production metrics.

Qualification: 

• High school diploma or equivalent.
• Strong attention to detail, critical thinking, and accuracy.
• Ability to manage multiple tasks, prioritize work, and meet deadlines in a fast-paced environment.
• Proficiency with Microsoft Office applications, including Word, Excel, Outlook, OneNote, and PowerPoint.
• Ability to navigate multiple computer applications efficiently, including use of keyboard shortcuts.
• Excellent organizational, interpersonal, written, and verbal communication skills.
• Strong customer service orientation, integrity, and personal accountability.
• Ability to learn benefit plans, systems, applications, and job-specific processes.
• Ability to type and use a keyboard for extended periods.
• Health insurance processing or related experience preferred.
• Work independently with strong self-discipline, accountability, and consistent follow-through.
• Participate effectively in a virtual work environment using Outlook, Teams, and other collaboration tools.
• Accept feedback, adapt to change, and apply coaching from supervisors, coaches, and trainers to improve processing techniques and workflows.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 17.75 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.