Claims Officer - Cigna Healthcare

Cigna; Muscat; On-site; OMR 18,000 - 27,000; Full time

Job summary

Cigna Healthcare in Oman seeks a Claims Associate Analyst to support accurate medical reimbursement and provider claim assessments. You will review medical information, policy benefits, and supporting documents to ensure fair, consistent, and timely decisions.

The role requires healthcare qualifications and 1–2 years in medical claims or related areas, with strong English communication and attention to detail. Collaborate with cross-functional teams in a fast-paced health insurance environment.

Qualifications

• Healthcare qualification such as MBBS or nursing degree.
• 1–2 years of experience in medical claims, preauthorization, or health insurance.
• Strong written and verbal communication in English.
• Knowledge of ICD/CPT coding and health insurance concepts.

Responsibilities

• Assess member reimbursement and provider claims accurately within quality standards.
• Review claims forms, medical reports, invoices, and supporting documentation.
• Validate eligibility, coverage, service dates, diagnoses, and coding.
• Explain claim decisions clearly to internal stakeholders and maintain auditable notes.
• Escalate complex or high-value cases as needed and obtain additional information.

Skills

Analytical thinking

Attention to detail

English communication

Prioritization

Team collaboration

Education

MBBS or equivalent medical degree

Bachelor of Nursing

Tools

Microsoft Office

Job description

About Cigna Healthcare

Cigna Healthcare is a global health service company dedicated to transforming healthcare. With roots in the U.S. and operations in over 30 countries, we serve more than 180 million customers and patients worldwide. Ranked 14th on the Fortune 500 in 2026, Cigna is recognized as one of the most trusted and influential names in the industry. Our mission is to improve the health, well-being, and peace of mind of those we serve. You'll join a globally recognized organization where trust, clear communication, and a positive culture shape how we work. Our leaders are consistent, approachable, and supportive, helping you maintain balance while doing meaningful work. We look for people who thrive in collaborative environments, care about meaningful change, and want to grow in a company that puts people first. At Cigna Healthcare, your work contributes to better care experiences and supports customers through important moments in their lives.

About the Role

As a Claims Associate Analyst within Cigna Middle East Claims Operations, you will support the accurate and timely assessment of medical reimbursement and provider claims. You will use your healthcare knowledge to review medical information, policy benefits, and supporting documentation to help ensure claims are assessed fairly, consistently, and accurately. This is a great opportunity for a healthcare-qualified professional who is analytical, detail-oriented, and interested in building a career in health insurance and claims operations.

What You'll Do

• Assess member reimbursement and provider claims accurately and within agreed quality, productivity, and turnaround-time standards.
• Review claim forms, medical reports, prescriptions, invoices, receipts, investigation results, proof of payment, and other supporting documentation.
• Validate member eligibility, coverage, dates of service, diagnoses, procedures, coding, billed amounts, provider details, and clinical evidence.
• Apply policy terms, benefits, limits, exclusions, clinical guidelines, pricing rules, deductibles, co-insurance, and member-share requirements.
• Assess medical necessity and ensure claimed services are supported by the diagnosis, documentation, and treatment provided.
• Identify incomplete documentation, duplicate or inconsistent billing, coding concerns, non-covered services, and unusual billing patterns.
• Maintain clear, complete, and auditable notes that support each claim decision.
• Request additional information when required and escalation complex, high-value, disputed, or medically unclear cases appropriately.
• Provide clear and professional explanations of claim decisions and documentation requirements to internal stakeholders.
• Handle confidential information responsibly and follow Cigna procedures, privacy standards, regulatory controls, and information-security requirements.

What You'll Bring

• A recognised healthcare qualification such as BDS, MBBS, BAMS, BHMS or equivalent medical degree, Bachelor of Nursing, or another relevant clinical or allied-health qualification.
• Applications are welcomed from healthcare-qualified candidates beginning their careers, as well as candidates with one to two years of experience in medical claims, preauthorisation, medical billing, provider operations, or health insurance.
• Sound knowledge of medical terminology, diagnoses, procedures, treatment pathways, and clinical documentation.
• Basic understanding of ICD, CPT, health insurance benefits, exclusions, deductibles, and co-insurance, with a willingness to develop further expertise.
• Strong written and verbal communication skills in English.
• Strong analytical and numerical skills with excellent attention to detail.
• Ability to manage priorities, meet deadlines, and handle confidential information appropriately.

Skills

Soft Skills

• Strong analytical thinking and sound judgement.
• Excellent attention to detail and commitment to accuracy.
• Clear and professional written and verbal communication skills.
• Ability to prioritize workload and work effectively within deadlines.
• Collaborative approach when working with different teams and stakeholders.
• Willingness to learn and develop within a fast-paced health insurance environment.

Technical / Functional Skills

• Knowledge of medical terminology, diagnoses, procedures, treatment pathways, and clinical documentation.
• Basic understanding of ICD and CPT coding.
• Understanding of health insurance benefits, exclusions, deductibles, and co-insurance.
• Ability to review and interpret medical records and supporting claim documentation.
• Ability to adapt to claims-processing systems and tools.
• Proficiency in Microsoft Office applications.

Nice to Have

• One to two years of experience in medical claims, preauthorization, medical billing, provider operations, or health insurance.
• Experience with reimbursement or provider claims.
• Experience working with international or Middle East medical claims.
• Previous exposure to healthcare or health insurance operations.

Why Join U