Health Claims Examiner Coach - Cigna Healthcare - Remote

Role Summary

Are you passionate about empowering people and driving high‑quality outcomes? As a Health Claims Examiner Coach (Claims Lead Representative), you will play a critical role in supporting and developing Claims Examiners through real‑time coaching, quality guidance, and process improvement. You will help foster a positive, team‑focused environment while ensuring accurate and timely claims processing aligned with Allegiance standards.

Key Responsibilities

• Provide real‑time support to Claims Examiners by answering questions and managing multiple chat inquiries to resolve claim issues efficiently
• Monitor and coach on quality and productivity metrics, including accuracy and lines per hour
• Teach and coach by demonstrating claim processing best practices, driving improved accuracy and consistency
• Review claims to identify accuracy trends and patterns, sharing insights with the team and leadership
• Support and drive process improvement initiatives to enhance claim accuracy and overall outcomes
• Encourage Claims Examiners to effectively use tools, resources, and references while building their technical skills
• Partner with the Team Leader to support monthly statistics, reporting, and performance reviews
• Assist with Nesting activities, helping new Claims Examiners transition successfully from training to production

Required Qualifications

• High School Diploma or GED (Bachelor’s degree preferred)
• Minimum 1 year of experience with Allegiance processes, systems, and resources, including LuminX
• Strong computer skills with proficiency in Microsoft Word, Outlook, and WebEx

Preferred Qualifications

• 1+ year of coaching, mentoring, or leadership experience
• 1+ year of experience with medical terminology and basic health insurance concepts
• Working knowledge of Excel and PowerPoint
• Ability to read and interpret benefit plans, insurance documents, and regulatory requirements
• Proven ability to work in a fast‑paced environment, manage multiple tasks, and solve problems effectively

Core Skills & Competencies

• Strong verbal and written communication skills
• Skilled listener with excellent interpersonal and teamwork abilities
• Customer‑focused mindset with attention to detail and accuracy
• Ability to motivate, influence, and support others in achieving performance goals

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.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

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 manner consistent with all federal, state and local ordinances.