Claims Representative

Cigna Health and Life Insurance Company; Riyadh; Hybrid; SAR 70,000 - 100,000; Full time

Benefits offered by this job

Hybrid mode

International exposure

Great Place to Work certification (KSA

Working hours: As per KSA Labor Law

Job summary

The Cigna Group is seeking a Claims Processing support specialist in the Middle East, based in Riyadh. The role focuses on organizing and tracking daily claim workflows to meet turnaround targets and handle queries from members and providers.

Strong interpersonal and medical terminology understanding are valued. The position involves handling claim batches, scanning, logging, planning processing schedules, and collaborating with the Claims Team to ensure timely resolutions.

Qualifications

• 1 year of experience in a similar role with admin and stakeholder contact.
• Experience with an international company is preferred but not required.
• Experience in claims or insurance is preferred but not essential.
• Broad awareness of medical terminology is advantageous.

Responsibilities

• Take receipt of claim batches from providers and members.
• Log and file claims for tracking, planning and processing.
• Scan and image hard-copy claims as received.
• Plan operations and create processing schedules for the team.
• Assemble processing batches and assign to team members.
• Update status in systems for finalized claims.
• Contact providers and members to obtain missing information.
• Respond to inbound queries and maximize first-time resolution.

Skills

Microsoft Office

Administrative skills

Time management

Communication skills

Customer service

Attention to detail

Independent & teamwork

Medical terminology basics

Tools

MS Office Suite

Job description

Job Overview

This role is at the heart of Cigna's claims processing operation in the Middle East. Claims are received from both members and providers, and the position holder will be required to organize and track workflow daily to facilitate the consistent attainment of turnaround times and other critical success factors for Claims. The position holder will also be expected to respond to queries regarding claims and coming from multiple in-house and external sources; thereby freeing the Cigna Claims Team to focus exclusively upon attaining daily targets. The role will be required to be organized and efficient and accurate with strong interpersonal skills, and preferably an appreciation of medical terms.

Responsibilities

• Take receipt of submitted claim batches from providers, and individual claims direct from members.
• Log and file claims received for tracking and planning and processing purposes.
• Scanning and imaging of hard-copy claims received.
• Operations planning; compiling processing schedules for the Claims Team.
• Assemble processing batches and assign to team members.
• Accepting finalized claims; updating status in systems and trackers as required.
• Reach out to providers and members; source additional information as needed to finalize claims.
• Resolve inbound queries from providers and members; maximize first time contact resolution.
• Regular claims status reporting, as specified.

Qualifications and Skills

• 1 year’s experience performing a similar role; combining administration and stakeholder contact.
• Experience of working for an international company, preferred but not essential.
• Previous claims or insurance experience preferred but not essential.
• Broad awareness of medical terminology, advantageous.
• Excellent organizational skills, capable of following and contributing to agreed procedure.
• Strong administration awareness and experience, essential.
• Strong skills in Microsoft Office applications, essential.
• First class written and verbal communication skills, essential.
• Ability to communicate across a diverse population, essential.
• Capable of working independently, or as part of a team.
• Good time management: ability to work to tight deadlines.
• Flexible and adaptable approach, sometimes working in a fast-paced environment.
• Passion for achieving agreed objectives.

What We Offer

• Hybrid mode
• Flexibly International exposure
• Pleasant environment (Cigna KSA got recently certified as "Great Place to Work")
• Working hours: As per KSA Labor Work

Company Information

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.

Equal Opportunity

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.