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Cigna Group

Sells health coverage and pharmacy benefits

Claims Officer

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeMuscat, OmanNo salary listed

About the Job

Requirements

  • A recognized healthcare qualification such as BDS, MBBS, BAMS, BHMS or an equivalent medical degree, a Bachelor of Nursing, or another relevant clinical or allied-health qualification.
  • Sound knowledge of medical terminology, diagnoses, procedures, treatment pathways, and clinical documentation.
  • Basic understanding of ICD and CPT coding, health insurance benefits, exclusions, deductibles, and co-insurance, with willingness to develop further expertise.
  • Strong written and verbal communication skills in English.
  • Strong analytical and numerical skills with attention to detail.
  • Ability to manage priorities, meet deadlines, and handle confidential information appropriately.
  • 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.

Responsibilities

  • 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.

Desired Qualifications

  • 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.

About the Company

Cigna Group

Sells health coverage and pharmacy benefits

The Cigna Group sells health coverage and pharmacy services to employers, health plans and individuals, and most of its business runs through Evernorth, its health services arm. Evernorth owns Express Scripts, one of the largest pharmacy benefit managers in the U.S., which negotiates drug prices and processes prescriptions for plan sponsors, plus the specialty pharmacy Accredo. Its Cigna Healthcare unit sells medical, dental and behavioral coverage, mostly to employers that fund their own plans, and earns premiums and administrative fees, while Evernorth earns service fees and drug margins. The company was formed in 1982 through the merger of Connecticut General and INA and is based in Bloomfield, Connecticut.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Bloomfield, CT
Founded
1982

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