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Remote Cigna Claims Representative Jobs in Colorado

Provide assistance to HCPs to compliantly troubleshoot claims at retail pharmacies for eligible ... Work and compliantly with field team representatives to receive engagement requests and communicate ...

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Remote Cigna Claims Representative information

What is a remote Cigna claims representative?

Remote Cigna Claims Representatives are professionals who work from home to review, process, and resolve insurance claims for Cigna, a major health services company. They ensure that medical claims are accurate, complete, and comply with company policies and industry regulations. These representatives communicate with healthcare providers, policyholders, and other departments to gather necessary information and resolve discrepancies. Their role is essential in ensuring customers receive timely and accurate reimbursements for healthcare services.

What skills and qualifications are needed to be a remote Cigna claims representative?

To thrive as a Remote Cigna Claims Representative, you need a solid understanding of health insurance policies, claims processing, and customer service principles, often requiring a high school diploma or equivalent. Familiarity with claims management software, CRM systems, and Microsoft Office Suite is typically expected. Strong attention to detail, problem-solving abilities, and effective communication are crucial soft skills for excelling in this role. These skills ensure accurate claims handling, efficient resolution of customer inquiries, and high-quality service delivery in a remote work environment.

What challenges do remote Cigna claims representatives face and how can they be managed?

Remote Cigna Claims Representatives often encounter challenges such as managing a high volume of claims, staying updated with ever-changing insurance policies, and ensuring clear communication with both providers and policyholders. Balancing productivity while maintaining accuracy and compliance is essential. To manage these challenges, it helps to develop strong organizational skills, regularly participate in training sessions, and utilize available digital tools for efficient workflow. Additionally, proactive communication with team members and supervisors can help resolve complex cases and foster a supportive remote work environment.

What is the difference between Remote Cigna Claims Representative vs Remote UnitedHealth Claims Specialist?

AspectRemote Cigna Claims RepresentativeRemote UnitedHealth Claims Specialist
Required CredentialsHigh school diploma or equivalent; insurance claims processing experience; knowledge of healthcare policiesHigh school diploma or equivalent; claims processing experience; familiarity with healthcare billing
Work EnvironmentRemote, home-based office; computer and phone requiredRemote, home-based; computer and communication tools needed
Employer & Industry UsageCigna insurance company; healthcare and insurance industryUnitedHealth Group; healthcare and insurance industry
Common Search & Comparison IntentYesYes

The Remote Cigna Claims Representative and Remote UnitedHealth Claims Specialist roles both involve processing healthcare claims remotely, requiring similar credentials and work environments. The main difference lies in the employer and specific insurance policies they handle. Both positions are popular among job seekers looking for remote healthcare insurance roles, with overlapping responsibilities and industry usage.

Is Cigna a good company to work for remotely?

Remote Cigna Claims Representatives typically report positive work environments with flexible schedules and remote work options. The company offers training and tools necessary for the role, and employee reviews often cite good benefits and support, though experiences can vary by individual. Overall, it is considered a reputable employer for remote healthcare claims roles.

Is remote Cigna Claims Representative a stressful job?

A remote Cigna Claims Representative role can involve handling a high volume of claims and customer inquiries, which may contribute to work-related stress. The job requires attention to detail, communication skills, and the ability to manage deadlines, but individual stress levels vary based on workload and personal coping strategies.

What are the most commonly searched types of Cigna Claims Representative jobs in Colorado?

The most popular types of Cigna Claims Representative jobs in Colorado are:

What are popular job titles related to Remote Cigna Claims Representative jobs in Colorado?

For Remote Cigna Claims Representative jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Remote Cigna Claims Representative jobs in Colorado look for?

The top searched job categories for Remote Cigna Claims Representative jobs in Colorado are:

What cities in Colorado are hiring for Remote Cigna Claims Representative jobs?

Cities in Colorado with the most Remote Cigna Claims Representative job openings:

Senior Auto Appraiser - Field for Colorado Springs, CO

USAA Careers

Colorado Springs, CO โ€ข On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New


Job description

Why USAA?

At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families.

Embrace a fulfilling career at USAA, where our core values โ€“ honesty, integrity, loyalty and service โ€“ define how we treat each other and our members. Be part of what truly makes us special and impactful.

We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs.

The Opportunity

This is a field-based role in Colorado Springs, Colorado and surrounding area. Candidates who are willing and able to work in Colorado Springs, CO area are encouraged to apply.

Within defined guidelines and framework responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Accountable for delivering exceptional member service through setting appropriate expectations, proactive communications, advice, and empathy.

What you'll do:

  • With the use of digital tools, evaluates and appraise highly complex auto physical damage claims in accordance with the terms and conditions of the contract, corporate guidelines and state laws and regulations.

  • Investigates claim damages including communicating with the insured, internal claims adjusters, and third parties/vendors. May require face-to-face interactions with members and third parties.

  • Reviews facts of loss and vehicle damage to determine if subrogation opportunities exist and ensures all supporting physical damage documentation is in the claim.

  • Demonstrates advanced knowledge of P&C insurance industry products, services, contracts, and internal processes/systems/procedures to ensure compliance with laws, regulations, and policy provisions.

  • Reviews claims/suppliers for fraud indicators and refers to Special Investigations Unit for handling, if applicable.

  • Maintains accurate and current claim file documentation throughout the claims process for complex claims.

  • Maintains high standards of productivity through effective desk management, timely follow ups, and accurate mapping of repair plans and timeline for repair in support of fast and accurate claims adjudication.

  • Responsible for reviewing additional damage received from repair facilities to either complete a supplement or triage to field provider method of inspection.

  • May serve as a subject matter expert representative for disputed claims or trials. Serves as a resource for team members on escalated issues of a routine nature.

  • Partners with vendors and internal business partners to facilitate highest complexity claims resolution. May also involve external regulatory coordination to ensure appropriate documentation and compliance.

  • Proactively provides policyholders with information regarding their coverage, repair estimate or total loss valuation, and claims/repair process while setting appropriate expectations.

  • Supports workload surges and catastrophe (CAT) response operations as needed, including mandatory on-call dates and potential evening, weekend, and/or holiday work outside normal work hours.

  • May be assigned CAT deployment travel with minimal notice during designated CATs.

  • Works various types of claims, including ones of higher complexity, and may be assigned additional work outside normal duties as needed.

  • Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

What you have:

  • High School Diploma or General Equivalency Diploma.

  • 2 years of auto appraising experience.

  • Proficient knowledge of P&C insurance policy contracts and coverages, auto parts distribution process and claim appraisal process and procedures.

  • Advanced working knowledge of estimating losses using CCC or similar estimating platforms.

  • Demonstrated written and verbal skills to communicate with members, claimants, repair facilities, and other internal and external stakeholders.

  • Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.

Physical Demand Requirements:

  • May require the ability to operate a company vehicle within assigned territory.

  • May require the ability to reach, handle, squat, bend, climb, and kneel as needed to complete inspections of damaged vehicles.

  • May require the ability to work outdoors in inclement weather conditions; May be exposed to working in body shop and/or salvage yard environments up to 25% of the time.

  • May be required to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license.

What sets you apart:

  • Active Texas or Florida All-Lines Adjusters License.

  • I-CAR ProLevel 3 (Platinum) certification or actively pursuing ProLevel 3.

  • Experience as a Field Auto Appraiser with a Property & Casualty (P&C) insurance carrier.

  • US military experience gained through military service or gained as a military spouse / domestic partner.

Compensation range: The salary range for this position is: $65,550 - $117,990.

USAA does not provide visa sponsorship for this role. Please do not apply for this role if at any time (now or in the future) you will need immigration support (i.e., H-1B, TN, STEM OPT Training Plans, etc.).

Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.

Employees may be eligible for pay incentives based on overall corporate and individual performance and at the discretion of the USAA Board of Directors.

The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job.

Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals.

For more details on our outstanding benefits, visit our benefits page on USAAjobs.com

Applications for this position are accepted on an ongoing basis, this posting will remain open until the position is filled. Thus, interested candidates are encouraged to apply the same day they view this posting.

 

USAA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.