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Claims Associate Analyst - Cigna Healthcare - Remote

Key Facts

Full time
English

Other Skills

  • Investigation
  • Professional Communication
  • Non-Verbal Communication
  • Analytical Skills
  • Time Management
  • Teamwork
  • Detail Oriented
  • Problem Solving

Roles & Responsibilities

  • Minimum Education: GED or High School Diploma
  • Experience in claims processing, insurance, customer advocacy, or related analytical/administrative role
  • Strong attention to detail and ability to review and interpret documentation
  • Effective written and verbal communication skills; ability to manage multiple priorities and meet deadlines

Requirements:

  • Investigate and evaluate insurance claims by reviewing claim forms, documentation, and related records to determine coverage
  • Determine coverage eligibility in accordance with policy terms and guidelines; negotiate claim settlements within established authority limits
  • Prepare and complete required documentation, analyses, and claim-related outputs accurately and on time
  • Identify trends or issues and provide recommendations for process improvements; prioritize assigned work and meet quality and productivity expectations

Job description

Job Summary

The Claims Associate Analyst provides analytical and administrative support within the Claims organization. This role is responsible for reviewing, investigating, and evaluating insurance claims to determine coverage and support fair, timely resolution. The position works independently on assigned tasks while receiving regular guidance and review from more experienced Claims professionals.


 

Key Responsibilities

  • Investigate and evaluate insurance claims by reviewing claim forms, documentation, and related records
  • Determine coverage eligibility in accordance with policy terms and guidelines
  • Use multiple methods of investigation to gather information and support claim resolution
  • Negotiate claim settlements with claimants within established authority limits
  • Communicate professionally with service providers, attorneys, policyholders, and other involved parties
  • Prepare and complete required documentation, analyses, and claim-related outputs accurately and on time
  • Identify trends or issues and provide recommendations for process improvements
  • Prioritize assigned work, manage deadlines, and meet quality and productivity expectations
  • Collaborate with Claims team members and escalate complex issues as appropriate

     

Qualifications Required:

  • Experience in claims processing, insurance, customer advocacy, or a related analytical or administrative role
  • Strong attention to detail and ability to review and interpret documentation
  • Effective written and verbal communication skills
  • Ability to manage multiple priorities and meet deadlines
  • Basic analytical and problem‑solving skills


 

Preferred:

  • Prior experience working with insurance claims or coverage determinations
  • Familiarity with claims systems and documentation standards
  • Experience communicating with external parties such as providers or legal representatives


 

Work Environment

  • Works under own initiative with regular review and oversight from senior Claims professionals
  • Role is subject to frequent feedback to support learning and development within the Claims job family


 

Minimum Education

  • GED or High School Diploma


 

About Allegiance by Cigna Healthcare

Since 1981, Allegiance by Cigna Healthcare has specialized in administering medical benefits, including claims processing, customer service, utilization management, and case management. With a high‑touch approach to member and client service, Allegiance supports some of the nation’s most innovative health benefit strategies.


If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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