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Cigna Group

Sells health coverage and pharmacy benefits

Provider Claims Representative

Claims AdjudicationPosted on Nov 4
Full-timeMadrid, SpainNo salary listed

About the Job

Requirements

  • A degree or equivalent experience in a field such as accountancy, mathematics, foreign languages, or administration is required.
  • Proficiency in English is required.
  • The role requires decision-making based on available information, numerical aptitude, accurate data input, adherence to procedures and document flows, efficiency, teamwork, proficiency in learning and using office applications, and responsible handling of confidential medical information.

Responsibilities

  • Assess and process medical expense claims while maintaining strict medical confidentiality.
  • Enter data accurately into PC and mainframe applications.
  • Apply analytical and critical thinking in cost management and process optimisation.
  • Monitor workload to maintain chronology and processing timelines, taking corrective action as needed.
  • Collaborate with the Supervisor on unclear claims and suggest process improvements.
  • Handle claims to support high-quality processing, accurate reimbursements, and timely transactions.
  • Communicate dossier details accurately to internal stakeholders.
  • Identify procedural irregularities and escalate them to the Supervisor.
  • Raise concerns or sensitivities promptly.
  • Contribute to a positive and cooperative team environment.

Desired Qualifications

  • Knowledge of additional languages such as Russian, Polish, Chinese, German, Dutch, French, Italian, Portuguese, or other European and Asian languages is an advantage.

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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