Provider Claims Representative
The Cigna Group
Provider Claims Representative
Job Description
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
Job Description Summary
We are seeking a detail-oriented professional to deliver administrative and business services within the Claims department. This role involves examining and processing paper and electronic claims, determining whether to return, pend, deny, or pay claims in line with company policies. You will adjudicate claims, settle with claimants according to policy provisions, and verify completeness and validity by comparing applications and provider statements with policy files and records.
You will interact with agents and claimants via mail to correct errors, resolve omissions, and investigate questionable entries. Most issues are routine in nature. A solid understanding of claims processes and operating procedures is essential. Work is performed under clearly defined guidelines and close supervision.
ABOUT US:
Cigna Corporation is a global health service company dedicated to improving the health, well-being, and peace of mind of those we serve. We provide healthcare products and services, as well as group disability, life, accident, and international insurance—directly to individuals and through employers and intermediaries.
YOUR MISSION:
Perform critical analysis and processing of medical expense claims within established turnaround times.
Key Responsibilities
Claims Processing
Assess and process medical expense claims while maintaining strict medical confidentiality.
Ensure accurate data entry into PC and mainframe applications.
Apply analytical and critical thinking in cost management and process optimisation.
Monitor workload to maintain chronology and processing timelines, taking corrective action as needed.
Collaborate with the Supervisor on unclear claims and suggest process improvements.
Strive for high-quality claims handling, accurate reimbursements, and timely transactions.
Collaboration
Communicate dossier details accurately to internal stakeholders.
Identify procedural irregularities and escalate to the Supervisor.
Raise concerns or sensitivities promptly.
Contribute to a positive and cooperative team environment.
Skills and Knowledge
Education
Degree or equivalent experience (e.g., accountancy, mathematics, foreign languages, administration).
Languages
Proficiency in English is required.
Knowledge of additional languages such as Russian, Polish, Chinese, German, Dutch, French, Italian, Portuguese, or other European and Asian languages is an advantage.
Core Skills
Decision-making: Ability to take appropriate action based on available information.
Numerical aptitude: Comfortable working with numbers.
Accuracy: Committed to error-free data input.
Discipline: Adheres to procedures and document flows.
Efficiency: Balances quality and productivity effectively.
Teamwork: Works collaboratively within a team.
Technical skills: Quick to learn and use office applications.
Discretion: Handles confidential medical information responsibly.
What We Offer
Long-term contract
Hybrid working model: Work from home 4 days per week and 1 day from our Madrid office (shuttle bus provided).
Flexible start times: Choose between 07:00 and 09:30 (Monday to Friday, morning intensive shift).
Comprehensive benefits: Private medical and dental insurance, life assurance, educational development programmes, foreign language scholarships, and flexible compensation options.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Locations
- Madrid, Spain
Salary
60,000 - 100,000 EUR / yearly
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Decision-makingintermediate
- Analytical and critical thinkingintermediate
- Claims processingintermediate
- Data entryintermediate
- English proficiencyintermediate
- Additional languages (Russian, Polish, Chinese, German, Dutch, French, Italian, Portuguese, other European/Asian)intermediate
Required Qualifications
- Degree or equivalent experience (accountancy, mathematics, foreign languages, administration) (experience)
Responsibilities
- Assess and process medical expense claims
- Ensure accurate data entry
- Apply analytical thinking in cost management
- Monitor workload and timelines
- Collaborate with Supervisor on unclear claims
- Communicate dossier details
- Identify procedural irregularities
- Contribute to team environment
Answer 10 quick questions to check your fit for Provider Claims Representative @ The Cigna Group.
Provider Claims Representative
The Cigna Group
Provider Claims Representative
Job Description
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
Job Description Summary
We are seeking a detail-oriented professional to deliver administrative and business services within the Claims department. This role involves examining and processing paper and electronic claims, determining whether to return, pend, deny, or pay claims in line with company policies. You will adjudicate claims, settle with claimants according to policy provisions, and verify completeness and validity by comparing applications and provider statements with policy files and records.
You will interact with agents and claimants via mail to correct errors, resolve omissions, and investigate questionable entries. Most issues are routine in nature. A solid understanding of claims processes and operating procedures is essential. Work is performed under clearly defined guidelines and close supervision.
ABOUT US:
Cigna Corporation is a global health service company dedicated to improving the health, well-being, and peace of mind of those we serve. We provide healthcare products and services, as well as group disability, life, accident, and international insurance—directly to individuals and through employers and intermediaries.
YOUR MISSION:
Perform critical analysis and processing of medical expense claims within established turnaround times.
Key Responsibilities
Claims Processing
Assess and process medical expense claims while maintaining strict medical confidentiality.
Ensure accurate data entry into PC and mainframe applications.
Apply analytical and critical thinking in cost management and process optimisation.
Monitor workload to maintain chronology and processing timelines, taking corrective action as needed.
Collaborate with the Supervisor on unclear claims and suggest process improvements.
Strive for high-quality claims handling, accurate reimbursements, and timely transactions.
Collaboration
Communicate dossier details accurately to internal stakeholders.
Identify procedural irregularities and escalate to the Supervisor.
Raise concerns or sensitivities promptly.
Contribute to a positive and cooperative team environment.
Skills and Knowledge
Education
Degree or equivalent experience (e.g., accountancy, mathematics, foreign languages, administration).
Languages
Proficiency in English is required.
Knowledge of additional languages such as Russian, Polish, Chinese, German, Dutch, French, Italian, Portuguese, or other European and Asian languages is an advantage.
Core Skills
Decision-making: Ability to take appropriate action based on available information.
Numerical aptitude: Comfortable working with numbers.
Accuracy: Committed to error-free data input.
Discipline: Adheres to procedures and document flows.
Efficiency: Balances quality and productivity effectively.
Teamwork: Works collaboratively within a team.
Technical skills: Quick to learn and use office applications.
Discretion: Handles confidential medical information responsibly.
What We Offer
Long-term contract
Hybrid working model: Work from home 4 days per week and 1 day from our Madrid office (shuttle bus provided).
Flexible start times: Choose between 07:00 and 09:30 (Monday to Friday, morning intensive shift).
Comprehensive benefits: Private medical and dental insurance, life assurance, educational development programmes, foreign language scholarships, and flexible compensation options.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Locations
- Madrid, Spain
Salary
60,000 - 100,000 EUR / yearly
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Decision-makingintermediate
- Analytical and critical thinkingintermediate
- Claims processingintermediate
- Data entryintermediate
- English proficiencyintermediate
- Additional languages (Russian, Polish, Chinese, German, Dutch, French, Italian, Portuguese, other European/Asian)intermediate
Required Qualifications
- Degree or equivalent experience (accountancy, mathematics, foreign languages, administration) (experience)
Responsibilities
- Assess and process medical expense claims
- Ensure accurate data entry
- Apply analytical thinking in cost management
- Monitor workload and timelines
- Collaborate with Supervisor on unclear claims
- Communicate dossier details
- Identify procedural irregularities
- Contribute to team environment
Answer 10 quick questions to check your fit for Provider Claims Representative @ The Cigna Group.