Claims Representative

5 days ago

Nairobi, Nairobi Area, Kenya The Cigna Group Full time 900,000 - 1,200,000 per year
The job profile for this position is Claims Representative, which is a Band 1 Professional Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

We are looking for a detail-oriented claims Representative to join our claims team. You will be responsible for verifying information and corresponding with agents and beneficiaries. You will also handle client inquiries, review policies, determine coverage, calculate claim amounts, and process payments.
To be successful as a claim's processor, you should have excellent organizational and interpersonal skills. You should also be able to work under pressure and perform a range of clerical functions with great attention to detail.
Main Duties / Responsibilities

  • A medical claims processor validates the information on all medical claims from patients seeking payment from the company. 
  • Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. 
  • In addition, a processor must keep meticulous records of claims and follow up on lapsed cases.
  • Medical claims processors are expected to have an extensive knowledge of medical terminology, as well as experience using a computer. 
  • Recording and maintaining insurance policy and claims information in a database system.
  • Determining policy coverage and calculating claim amounts.
  • Processing claims payments.
  • Answering queries related to Policy coverage criteria and guidelines.
  • Complying with federal, state, and company regulations and policies.
  • Since medical claims processors must approve or deny payment to doctors, it is vital that they know how to correctly read and assess medical documents. 
  • Good communication skills are necessary to converse with doctors' offices or insurance companies if there is a problem with the claim.
  • Performing other clerical tasks, as required.

Claims Processor Requirements:

  • Diploma or Degree Qualification.
  • Knowledge of Medical Terminologies, CPT codes and ICD-9 codes is an added advantage.
  • Computer literate and proficient in MS Office.
  • Excellent critical thinking and decision-making skills.
  • Good administrative and organizational skills.
  • Strong customer service skills.
  • Ability to work under pressure.
  • High attention to details

Please note that you must meet our posting guidelines to be eligible for consideration.  Policy can be reviewed at this link.

  • Claims Representative

    5 days ago

    Nairobi, Nairobi Area, Kenya The Cigna Group Full time $40,000 - $60,000 per year

    We are looking for a detail-oriented claims Representative to join our claims team. You will be responsible for verifying information and corresponding with agents and beneficiaries. You will also handle client inquiries, review policies, determine coverage, calculate claim amounts, and process payments.To be successful as a claim's processor, you should...

  • Claims Representative

    5 days ago

    Nairobi, Nairobi Area, Kenya Cigna Healthcare Full time $40,000 - $60,000 per year

    We are looking for a detail-oriented claims Representative to join our claims team. You will be responsible for verifying information and corresponding with agents and beneficiaries. You will also handle client inquiries, review policies, determine coverage, calculate claim amounts, and process payments.To be successful as a claim's processor, you should...

  • Intake Care Representative

    5 days ago

    Nairobi, Nairobi Area, Kenya The Cigna Group Full time $40,000 - $60,000 per year

    The job profile for this position is Intake Care Representative, which is a Band 1 Professional Career Track Role.Excited to grow your career?We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for...

  • Intake Care Representative

    5 days ago

    Nairobi, Nairobi Area, Kenya The Cigna Group Full time $40,000 - $80,000 per year

    Intake Care Representative (French, Portuguese, Spanish, German)What does Cigna do?Cigna provides health insurance services around the world. We're passionate about helping people improve their health, well-being, and sense of security. We started over 200 years ago and we continued to innovate and expand ever since. At Cigna Health Benefits we focus on the...

  • Intake Care Representative

    5 days ago

    Nairobi, Nairobi Area, Kenya Cigna Healthcare Full time $40,000 - $80,000 per year

    Intake Care Representative (French, Portuguese, Spanish, German)What does Cigna do? Cigna provides health insurance services around the world. We're passionate about helping people improve their health, well-being, and sense of security. We started over 200 years ago and we continued to innovate and expand ever since. At Cigna Health Benefits we focus on the...

  • Senior Full Stack Engineer

    5 days ago

    Nairobi, Nairobi Area, Kenya KenyaMOJA Full time $90,000 - $120,000 per year

    Job Description/RequirementsAbout ZiplineDo you want to change the world? Zipline is on a mission to transform the way goods move. Our aim is to solve the world's most urgent and complex access challenges by building, manufacturing and operating the first instant delivery and logistics system that serves all humans equally, wherever they are. From powering...

  • Medical Advisor

    3 days ago

    Nairobi, Nairobi Area, Kenya The Cigna Group Full time $70,000 - $120,000 per year

    The Medical Advisor is a member of the medical team, part of IHT, who develops and manages health and wellness programs for Cigna customers. Together with a team of nurses and physicians she/he will ensure attainment of quality, production, timeliness, customer advocacy, cost containment goals, and excellent customer satisfaction for both internal and...

  • Chief Commercial Officer

    5 days ago

    Nairobi, Nairobi Area, Kenya Directline Assurance Company Limited Full time $90,000 - $120,000 per year

    The role Key Roles & ResponsibilitiesBusiness Growth & Revenue Generation Develop and execute short and long-term commercial strategy to that will drive compelling revenue growth and profitability. Proactively identify commercial opportunities, partnerships and market segments for expansion. Develop commercial models and drive technology optimization to...

  • Order and Delivery Specialist

    5 days ago

    Nairobi, Nairobi Area, Kenya Polarium Full time $60,000 - $80,000 per year

    Polarium manufactures intelligent energy storage systems that have the potential to change the way we think about energy. Our team has a proven track record of finding unique business opportunities all over the world and attracting a loyal customer base. With us, you'll be the voice of the company and communicate our market-leading technology throughout our...