We need a Claims Officer,
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 escalate 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 Us
Competitive salary.
Multicultural and hybrid working environment.
Private Medical Insurance.
Employee Wellbeing Benefits.
Educational Development Program.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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: SeeYourselfEMEAcigna.com for support. Do not emailSeeYourselfEMEAcigna.com for an update on your application or to provide your resume as you will not receive a response.
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