Job description

Based in Riyadh, Saudi Arabia, the Claims Lead Analyst for The Cigna Group is a detail-oriented insurance role responsible for preparing claim forms, verifying information, corresponding with agents and beneficiaries, handling client inquiries, reviewing policies to determine coverage, calculating claim amounts, and processing payments. The role validates information on all medical claims, thoroughly reviews submissions to prevent missing or incomplete data, maintains meticulous claim records, and follows up on lapsed cases. It requires extensive knowledge of medical terminology, CPT codes, and ICD-9 codes, the ability to correctly read and assess medical documents, and proficiency with computers and MS Office while recording and maintaining insurance policy and claims information in a database system. The position determines policy coverage, processes payments, answers queries related to policy coverage criteria and guidelines, complies with federal, state, and company regulations and policies, and performs other clerical tasks as required. Context includes technical expertise with depth or breadth in claims; researching and resolving escalated and complex claim issues in a timely manner; identifying error trends and notifying appropriate areas for correction; communicating and educating necessary parties; recommending process improvements; communicating with service providers, attorneys, policyholders, and other involved parties; providing guidance, coaching, and direction to junior team members; and acting independently under limited supervision, with the ability to work under pressure and maintain high attention to detail.