Claims Representative - Cigna Healthcare

cigna; Riyadh; Hybrid; SAR 45,000 - 75,000; Full time

Benefits offered by this job

Hybrid mode

Flexibility

International exposure

Great Place to Work acknowledgment for

Pleasant environment

Job summary

Cigna in Riyadh is seeking a Claims Processing Associate to organize and track daily workflows, respond to claims queries, and support the Claims Team to achieve daily turnaround targets. The role requires strong interpersonal skills, excellent organization, and familiarity with medical terminology.

You will handle claim receipts from providers and members, log and file claims, scan hard-copy submissions, plan schedules, and coordinate processing batches.

Qualifications

• 1 year of experience in a similar administrative/claims support role.
• Experience in an international company preferred but not required.
• Experience in claims or insurance is preferred but not essential.
• Broad awareness of medical terminology advantageous.
• Excellent organizational and administration skills.
• First-class written and verbal communication skills.
• Ability to communicate across a diverse population.
• Capable of working independently or as part of a team.
• Strong time management and ability to meet deadlines.
• Flexible and adaptable in a fast-paced environment.

Responsibilities

• Receive claim batches from providers and members.
• Log and file claims for tracking and processing.
• Scan and image hard-copy claims.
• Plan operations and processing schedules for the team.
• Assemble processing batches and assign to team members.
• Update statuses in systems and trackers.
• Reach out to providers and members to gather missing information.
• Address inbound queries and maximize first-time contact resolution.
• Prepare regular claims status reports.

Skills

Organizational skills

Stakeholder communication

Microsoft Office

Written and verbal communication

Time management

Independent / team working

Medical terminology familiarity

Tools

Microsoft Office

Job description

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.

Qualification and Skills :

• 1 years’ 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

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.

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.

If you require reasonable accommodation in completing the online application process, please email: [e-mail] for support. Do not email [e-mail] for an update on your application or to provide your resume as you will not receive a response.