{"schemaVersion":"jobsearcher.job.v1","id":"ade85d8134e14f8cd951413e","url":"https://jobsearcher.com/jobs/ade85d8134e14f8cd951413e","canonicalUrl":"https://jobsearcher.com/jobs/ade85d8134e14f8cd951413e","title":"Claims Representative - Remote","description":"Claims Representative – Remote\nSUMMARY\nThe claims representative is responsible for manually reviewing and processing medical, supplemental, or dental claims. Claims are processed according to benefits, eligibility, and internal processes, policies, and procedures and may be completed, held for additional information/review, or denied. New claim representatives will be provided with a robust training program, which includes virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements over several months. After completion of training, claim representatives must meet specific accuracy/quality, volume/claims per hour, and on production performance metrics.\n$19/Hour Pay Rate\nRESPONSIBILITIES\nIndependently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines.\nConfirm the presence of necessary documents within submitted claims.\nValidate the accuracy of medical codes provided in claim submissions.\nAssess the eligibility status of claims based on established criteria.\nReview and verify other insurance coverage information in submitted claim.\nEvaluate authorizations provided in claim submissions for accuracy.\nAnalyze account benefit plans to ensure claims align with coverage and policies.\nIdentify discrepancies, errors, or missing information.\nUtilize multiple computer applications simultaneously.\nMaintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/responsibilities while working without close supervision.\nMeet or exceed quality and productivity goals.\nIdentify claim processing learning opportunities by working directly with supervisors, coaches, and trainers to learn efficient and effective processing techniques and workflows.\nUtilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors.\nQUALIFICATIONS\nHigh school diploma or equivalent\nAbility to quickly learn a variety of computer applications to complete job functions,\nExperience sending/receiving emails, scheduling calendar appointments/sending invitations, attaching files in Microsoft Outlook.\nKnowledge of basic Microsoft Excel functions, such as filtering/sorting.\nExperience in navigating multiple computer applications through the use of shortcut keys and other techniques.\nDetail-oriented with experience in applying complex policy/procedure documents.\nStrong organizational skills to maximize available work time. Ability to prioritize tasks to ensure job tasks are completed before deadlines.\nProven experience completing work with quality and productivity performance standards.\nExperience working independently in a virtual environment preferred.\nExperience with medical and insurance terminology in a professional setting preferred.\nKnowledge of CPT/ICD-10 codes preferred.\nProven experience in health insurance claims processing or similar field preferred\n\nIf 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.\nFor this position, we anticipate offering an hourly rate of 17.75 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.\nThis role is also anticipated to be eligible to participate in an annual bonus plan.\n\nAt 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.\n\nAbout The Cigna Group\nDoing 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.\nQualified 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.\nIf 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.\nThe 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.\nQualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.","company":"Cigna","rawCompany":"cigna group","isRemote":true,"isActive":false,"createdAt":"2026-08-15T13:42:53.361Z","occupations":[{"code":"43-9041.00","title":"Insurance Claims and Policy Processing Clerks","slug":"insurance-claims-and-policy-processing-clerks"},{"code":"13-1031.00","title":"Claims Adjusters, Examiners, and Investigators","slug":"claims-adjusters-examiners-and-investigators"},{"code":"41-3021.00","title":"Insurance Sales Agents","slug":"insurance-sales-agents"}],"industries":[{"code":"524298","title":"All Other Insurance Related Activities","slug":"all-other-insurance-related-activities"},{"code":"524291","title":"Claims Adjusting","slug":"claims-adjusting"},{"code":"524292","title":"Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds","slug":"pharmacy-benefit-management-and-other-third-party-administration-of-insurance-and-pension-funds"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Claims Representative - Remote","description":"Claims Representative – Remote\nSUMMARY\nThe claims representative is responsible for manually reviewing and processing medical, supplemental, or dental claims. Claims are processed according to benefits, eligibility, and internal processes, policies, and procedures and may be completed, held for additional information/review, or denied. New claim representatives will be provided with a robust training program, which includes virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements over several months. After completion of training, claim representatives must meet specific accuracy/quality, volume/claims per hour, and on production performance metrics.\n$19/Hour Pay Rate\nRESPONSIBILITIES\nIndependently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines.\nConfirm the presence of necessary documents within submitted claims.\nValidate the accuracy of medical codes provided in claim submissions.\nAssess the eligibility status of claims based on established criteria.\nReview and verify other insurance coverage information in submitted claim.\nEvaluate authorizations provided in claim submissions for accuracy.\nAnalyze account benefit plans to ensure claims align with coverage and policies.\nIdentify discrepancies, errors, or missing information.\nUtilize multiple computer applications simultaneously.\nMaintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/responsibilities while working without close supervision.\nMeet or exceed quality and productivity goals.\nIdentify claim processing learning opportunities by working directly with supervisors, coaches, and trainers to learn efficient and effective processing techniques and workflows.\nUtilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors.\nQUALIFICATIONS\nHigh school diploma or equivalent\nAbility to quickly learn a variety of computer applications to complete job functions,\nExperience sending/receiving emails, scheduling calendar appointments/sending invitations, attaching files in Microsoft Outlook.\nKnowledge of basic Microsoft Excel functions, such as filtering/sorting.\nExperience in navigating multiple computer applications through the use of shortcut keys and other techniques.\nDetail-oriented with experience in applying complex policy/procedure documents.\nStrong organizational skills to maximize available work time. Ability to prioritize tasks to ensure job tasks are completed before deadlines.\nProven experience completing work with quality and productivity performance standards.\nExperience working independently in a virtual environment preferred.\nExperience with medical and insurance terminology in a professional setting preferred.\nKnowledge of CPT/ICD-10 codes preferred.\nProven experience in health insurance claims processing or similar field preferred\n\nIf 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.\nFor this position, we anticipate offering an hourly rate of 17.75 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.\nThis role is also anticipated to be eligible to participate in an annual bonus plan.\n\nAt 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.\n\nAbout The Cigna Group\nDoing 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.\nQualified 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.\nIf 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.\nThe 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.\nQualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.","datePosted":"2026-08-15T13:42:53.361Z","dateModified":"2026-08-15T13:42:53.361Z","hiringOrganization":{"@type":"Organization","name":"Cigna","sameAs":"https://jobsearcher.com"},"jobLocationType":"TELECOMMUTE","applicantLocationRequirements":{"@type":"Country","name":"US"},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"ade85d8134e14f8cd951413e"},"url":"https://jobsearcher.com/jobs/ade85d8134e14f8cd951413e"}}