Claims Lead Analyst

Claims Lead Analyst

Join to apply for the

Claims Lead Analyst

role at

The Cigna Group . We are looking for a detail-oriented Claims Analyst Lead to join our insurance team. You will be responsible for preparing claim forms, verifying information, corresponding with agents and beneficiaries, handling client inquiries, reviewing policies, determining coverage, calculating claim amounts, and processing payments. Responsibilities

A medical claims processor validates the information on all medical claims from patients seeking payment from their insurance company. Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. Keep meticulous records of claims and follow up on lapsed cases. Have an extensive knowledge of medical terminology and experience using a computer. Record and maintain insurance policy and claims information in a database system. Determine policy coverage and calculate claim amounts. Process claims payments. Answer queries related to policy coverage criteria and guidelines. Comply with federal, state, and company regulations and policies. Read and assess medical documents to approve or deny payment to doctors. Communicate with doctors’ offices or insurance companies if there is a problem with the claim. Perform other clerical tasks as required. Qualifications

Medical qualification background will be an added advantage. At least 5 years of experience as a claim or in a related role. Knowledge of medical terminologies, CPT codes and ICD-9 codes. Working knowledge of the insurance industry and relevant federal and state regulations. Computer literate and proficient in MS Office. Excellent critical thinking and decision-making skills. Good administrative and organizational skills. Strong customer service skills. Ability to work under pressure. High attention to detail. 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 : for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

#J-18808-Ljbffr