Top 414 Claims representative Jobs in Pennsylvania

Claims Representative - Remote
The Cigna Group —Pennsylvania
- $17.75 - $26.00 an hour
- Online Application
- Remote
- Microsoft Outlook
- Research
- High school diploma or GED
- Paid holidays
- Health insurance
Commercial Business Insurance Agent
The Hess Agency —Manheim, PA
- Full-time
- High school
- Mid-level
- Office
- Profit sharing
- AD&D insurance
Quick Apply
Medical Biller
Retina Vitreous Consultants Inc. —Monroeville, PA
- $20 - $26 an hour
- Full-time
- Background check
- Mid-level
- High school diploma or GED
- Health savings account
- Health insurance
Quick Apply
Hospital Revenue Recovery Analyst, Level 1
Audley Revenue Solutions, LLC —Pittsburgh, PA
- $55,000 - $62,000 a year
- Full-time
- Microsoft PowerPoint
- Microsoft Word
- Background check
- Free parking
- Health insurance
Quick Apply
Claims Processor
Goodville Mutual Casualty Company —New Holland, PA
- Full-time
- Computer literacy
- Bachelor of Science
- Office
- On-the-job training
In-House Pharmacy Call Center Representative
KeyScripts, LLC —Mechanicsburg, PA
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Office
- Health insurance
- Dental insurance
Quick Apply
Coordinator - Insurance Compliance & Claims
Penske —Reading, PA
- Pass drug screening
- Research
- Mid-level
Accounts Receivable/Medical Biller
Ophthalmic Partners PC —Bala-Cynwyd, PA
- $23 - $25 an hour
- Full-time
- Mid-level
- In-person
- 4 years
- Health insurance
- Dental insurance
Quick Apply
Workers' Compensation Associate Claim Representative - Eastern Alliance
ProAssurance —Lancaster, PA
- $19.43 - $32.06 an hour
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- Office
10d
Insurance Sales Representative(Training Provided!!!)
Aflac —King of Prussia, PA
- $50,000 - $65,000 a year
- Full-time
- 18 years or older
- Office
- Driver's License
- AD&D insurance
- Dental insurance
Quick Apply
3d
Financial Recovery Analyst
Select Medical —Camp Hill, PA
- Full-time
- Research
- Mid-level
- Office
- Dental insurance
- Paid time off
Quick Apply
Dental Billing Representative
Chord Specialty Dental Partners —West Chester, PA
- $21 - $28 an hour
- Full-time
- Hybrid work
- Dental office
- Computer literacy
- Pediatrics
- Paid holidays
- Disability insurance
Quick Apply
Pharmacy Billing Associate
Grane Rx —Pittsburgh, PA
- Weekends as needed
- Background check
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
2d
HVAC Customer Service Representative
UGI HVAC —Exton, PA
- Computer literacy
- Residential
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
Insurance Sales Representative
StaffMyAgency LLC —Bethel Park, PA
- $45,000 - $75,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Paid time off
- Opportunities for advancement
Quick Apply
11d
Licensed Insurance Sales Representative
StaffMyAgency LLC —Oxford, PA
- $50,000 - $75,000 a year
- Urgently hiring
- Spanish
- English
- Office
- Health insurance
- Paid time off
Quick Apply
8d
Insurance Inside Sales Representative
Kelly Agency —Pottstown, PA
- $70,000 - $100,000 a year
- Full-time
- Hybrid work
- Computer literacy
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Quick Apply
12d
Licensed Insurance Sales Representative
StaffMyAgency LLC —Salem, PA
- $30,000 - $65,000 a year
- Urgently hiring
- Office
- Communication skills
- Marketing
Quick Apply
11d
Licensed Insurance Sales Representative
StaffMyAgency LLC —Lower Merion, PA
- $60,000 - $75,000 a year
- Urgently hiring
- Office
- In-person
- Communication skills
- 401(k)
- Opportunities for advancement
Quick Apply
3d
Customer Service Representative - State Farm Agent Team Member
Sean Black - State Farm Agent —Bloomsburg, PA
- $40,000 - $45,000 a year
- Full-time
- Office
- Communication skills
- Entry level
- Health insurance
- Paid time off
Quick Apply

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Claims Representative - Remote

The Cigna Group -
Pennsylvania

Apply Now

Job Details

Full-time
$17.75 - $26.00 an hour

Benefits

Paid holidays
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Smoking cessation program
Vision insurance
Life insurance

Qualifications

Video conferences (communication methods)

Full Job Description

Claims Representative – Remote

SUMMARY
The claims representative is responsible for manually reviewing and processing medical, supplemental, or dental claims. Claims are processed according to benefits, eligibility, and internal processes, policies, and procedures and may be completed, held for additional information/review, or denied. New claim representatives will be provided with a robust training program, which includes virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements over several months. After completion of training, claim representatives must meet specific accuracy/quality, volume/claims per hour, and on production performance metrics.

$19/Hour Pay Rate

RESPONSIBILITIES

Independently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines.
Confirm the presence of necessary documents within submitted claims.
Validate the accuracy of medical codes provided in claim submissions.
Assess the eligibility status of claims based on established criteria.
Review and verify other insurance coverage information in submitted claim.
Evaluate authorizations provided in claim submissions for accuracy.
Analyze account benefit plans to ensure claims align with coverage and policies.
Identify discrepancies, errors, or missing information.
Utilize multiple computer applications simultaneously.
Maintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/responsibilities while working without close supervision.
Meet or exceed quality and productivity goals.
Identify claim processing learning opportunities by working directly with supervisors, coaches, and trainers to learn efficient and effective processing techniques and workflows.
Utilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors.

QUALIFICATIONS

High school diploma or equivalent
Ability to quickly learn a variety of computer applications to complete job functions,
Experience sending/receiving emails, scheduling calendar appointments/sending invitations, attaching files in Microsoft Outlook.
Knowledge of basic Microsoft Excel functions, such as filtering/sorting.
Experience in navigating multiple computer applications through the use of shortcut keys and other techniques.
Detail-oriented with experience in applying complex policy/procedure documents.
Strong organizational skills to maximize available work time. Ability to prioritize tasks to ensure job tasks are completed before deadlines.
Proven experience completing work with quality and productivity performance standards.
Experience working independently in a virtual environment preferred.
Experience with medical and insurance terminology in a professional setting preferred.
Knowledge of CPT/ICD-10 codes preferred.
Proven experience in health insurance claims processing or similar field preferred

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.

For this position, we anticipate offering an hourly rate of 17.75 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs,click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 emailseeyourselfthecignagroup.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 mannerconsistent with all federal, state and local ordinances.

Apply Now

Refine Your Search

claims representative jobs in pennsylvania

Claims Representative - Remote

Commercial Business Insurance Agent

Medical Biller

Hospital Revenue Recovery Analyst, Level 1

Claims Processor

In-House Pharmacy Call Center Representative

Coordinator - Insurance Compliance & Claims

Accounts Receivable/Medical Biller

Workers' Compensation Associate Claim Representative - Eastern Alliance

Insurance Sales Representative(Training Provided!!!)

Financial Recovery Analyst

Dental Billing Representative

Pharmacy Billing Associate

HVAC Customer Service Representative

Insurance Sales Representative

Licensed Insurance Sales Representative

Insurance Inside Sales Representative

Licensed Insurance Sales Representative

Licensed Insurance Sales Representative

Customer Service Representative - State Farm Agent Team Member

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