Claims Senior Representative - The Cigna Group

This is a temporary contract opportunity with The Cigna Group through Magnit, an enterprise third-party vendor for contingent work. 

Role: Claims Senior Representative

Remote - 33314770

Overview

Delivers specific delegated claims tasks assigned by a supervisor. Examines electronic claim denials to determine the next action. Follows established departmental and corporate policies and procedures. Reconcile on account payments and adjustments to ensure the correct amounts have been applied per the EOB. Research credit balances on accounts to resolve overpayment issues and process refunds accordingly. Identifying trends in erroneous postings and reporting findings to a supervisor. Engage with agents and/or patients through email and phone to address claim discrepancies and reprocess claims as needed. Complete claim denials without direct supervision and seek understanding of unfamiliar claims when necessary.

Essential Functions:

• Ability to multi-task in multiple systems
• Basic knowledge of health insurance billing
• Knowledgeable in assessing explanation of benefits (EOBs) from insurance companies (payer portals)
• Attention to detail
• Ability to process a high volume of claims corrections, 100+ claims per day
• The ability to identify and resolve payment posting issues.
• Consistently meets agreed-upon department metrics.
• The ability to identify an overpayment and determine when a refund is due (patients/insurance).
• The ability to research and resolve simple to complex issues and or escalate issues to management when necessary.
• Provided excellent customer service to patients and insurance companies.
• At least 1 year of experience in medical insurance billing
• Ability to work independently and as part of a team.

Skills & Experience:

This position includes fiduciary duty or access to financial systems: Yes

• REQUIRED - Recent experience (within 2 years) with Athena Health
• REQUIRED – Basic Excel skills
• REQUIRED – Past experience using payer websites such as Availity

Education:

• High School Diploma

Location and Schedule Notes

• This is a fully remote role open to candidates across the US
• Monday - Friday 8:30am - 5pm EST (flexible)
• Training Schedule will be the same

Hourly Pay Rate Range (dependent on location, experience, expectation)

The pay range that Magnit reasonably expects to pay for this position is: $12.93-$17.24/hr

Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met)