Claims Representative

Cigna Health and Life Insurance Company; India; On-site; INR 600,000 - 800,000; Full time

Job summary

The Cigna Group, through Cigna Healthcare, is hiring for a Claims Processing role in Bengaluru. The candidate will adjudicate international health claims, handle data and documentation, and support SLA-driven workflows in a busy claims centre.

You will coordinate with teams and stakeholders to resolve inquiries, identify improvements, and ensure accurate processing while maintaining high service standards.

Qualifications

• Minimum 2–4 years of experience in processing of global healthcare insurance claims.
• Graduate qualification in medical, paramedical, commerce, statistics, mathematics, economics or science.
• Strong written and verbal English communication with keen attention to detail.

Responsibilities

• Adjudicate international claims in accordance with policy terms and conditions.
• Monitor SLA times to ensure claims are settled within required time scales.
• Respond to all claim enquiries within SLA, aiming for first-contact resolution.
• Communicate effectively with internal and external stakeholders to deliver excellent customer outcomes.
• Identify potential process improvements and make recommendations to team seniors.
• Actively support other team members and provide resources to meet goals.
• Carry out ad-hoc tasks as required to meet business needs.
• Work cohesively in a team environment and adhere to policies and training requirements.

Skills

Insurance claims processing

English communication

Attention to detail

Time management

Education

Graduate (Any) - medical, paramedical, commerce, statistics, mathematics, economics or science

Tools

MS Office

Job description

About Us

At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day. One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being. CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization. Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us!

Process Overview

EU insurance claims processing for individual, employer, group, and provider.

Job Description

Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles.

Responsibilities

• Adjudicate international claims in accordance with policy terms and conditions.
• M Monitor SLA times to ensure your claims are settled within required time scales.
• Respond to all claim enquiries within set SLA performing the necessary action as required, striving for first contact resolution where possible.
• Communicate effectively with internal and external stakeholders to deliver excellent customer outcomes.
• Identify potential process improvements and make recommendations to team senior.
• Actively support other team members and provide resource to enable all team goals to be achieved.
• Carry out other adhoc tasks as required in meeting business needs.
• Work cohesively in a team environment.
• Adhere to policies and practices, training, and certification requirements.

Requirements

• Working knowledge of the insurance industry and relevant federal and state regulations.
• Good English language communication skills, both verbal and written.
• Computer literate and proficient in MS Office.
• Excellent critical thinking and decision-making skills.
• Ability to meet/exceed targets and manage multiple priorities.
• Must possess excellent attention to detail, with a high level of accuracy.
• Strong interpersonal skills.
• Strong customer focus with ability to identify and solve problems.
• Ability to work under own initiative and proactive in recommending and implementing process improvements.
• Ability to organise, prioritise and manage workflow to meet individual and team requirements.
• Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential.

Education

Graduate (Any) - medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science.

Experience Range

Minimum 2 years and up to 4 years of experience in processing of global healthcare insurance claims.

Foundational Skills

• Expertise in EU insurance claims processing

Work Timings

1:00-10:00 PM IST

Job Location

Bengaluru (Bangalore)

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. 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.