Job Closed

This listing is no longer active.

Plan Automation Senior Representative - Cigna Healthcare - Remote

SalesSalesOtherRemoteSeniorTeam 10,001+Since 1982H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

98 days ago

Salary

0

Seniority

Senior

No structured requirement data.

Job Description

Plan Automation Senior Representative - Cigna Healthcare - Remote

The Cigna Group

Job Summary This role is responsible for building, maintaining, and supporting medical, dental, and vision benefit plans within the claims processing system. The position ensures accurate plan configuration, updates, and support to enable smooth claims processing and successful new group implementations. Key Responsibilities - Lead the configuration, maintenance, and optimization of medical, dental, and vision benefit plans within claims processing systems. - Design, build, and maintain deductibles, coinsurance, out‑of‑pocket maximums, benefit codes, and plan details aligned to approved plan documents. - Configure benefit logic based on provider type, specialty, place of service, procedures, and diagnoses to ensure accurate claims adjudication. - Interpret complex plan documents, benefit summaries, and translate them into system configuration and coding. - Maintain benefit definitions, benefit levels, plan maximums, exception codes, and benefit reporting with a high degree of accuracy. - Partner with claims, health services, and operational teams to support new group implementations and resolve plan or benefit configuration issues. - Review plan amendments and lead timely system updates to ensure compliance and operational readiness. - Analyze claims processing issues, identify root causes, and recommend efficient solutions. - Run and interpret reports and data searches to support audits, issue resolution, and ongoing plan maintenance. - Demonstrate deep understanding of claims processing workflows. - Apply strong analytical, problem‑solving, and decision‑making skills in a fast‑paced environment. - Leverage medical terminology, health insurance concepts, and basic mathematical principles to support accurate benefit configuration. - Ability to learn and apply system‑specific coding or configuration logic required to support claims processing platforms. - Exhibit strong organizational skills with the ability to manage multiple plan components, priorities, and deadlines simultaneously. - Communicate effectively and collaborate with cross‑functional while maintaining a professional demeanor. - Maintain strict adherence to confidentiality, privacy, and data protection standards. - Demonstrate flexibility, accountability, and professionalism while working under pressure. Requirements - High School Diploma or GED required. - 2+ years’ experience with medical claims, processing & benefits is preferred. - Ability to read, interpret, and apply plan documents accurately. - Strong attention to detail and ability to manage multiple plan components. - Strong problem‑solving and analytical skills. - Ability to collaborate effectively with cross‑functional teams. - Training in medical terminology & health benefits is preferred. - Experience with claims processing systems and reporting tools is preferred. - Experience with VBA software is preferred. About Allegiance by Cigna Healthcare Since 1981, Allegiance by Cigna Healthcare has specialized in administering medical benefits, including claims processing, customer service, utilization management, and case management. With a high‑touch approach to member and client service, Allegiance supports some of the nation’s most innovative health benefit strategies. 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.

Related Job Pages

More Sales Jobs

SureGuard logo

Remote Customer Sales Representatives

SureGuard

This is a 1099 independent contractor commission-based role with unlimited earning potential. International candidates are not eligible for this position. You'll be offering financial products like Indexed Universal Life (IUL), annuities, life insurance, and more to individuals seeking further details.

Sales98 days ago
OtherRemoteTeam 11-50

Remote Client Sales Representative - Accelerate Your Career with Us! Are you a driven individual looking for a flexible and rewarding sales career? Join our team as a Client Sales Representative and leverage our exceptional company culture, rapid growth opportunities, and extensive support to excel in the comfort of your home office. Why Choose Us? - Exceptional Culture: Recognized for our outstanding company culture by Entrepreneur Magazine and highly rated on Glassdoor and Indeed. - Full-time opportunity offering consistent hours, stable income potential, and long-term career growth within a supportive remote environment. - Steady Growth: Listed on the Inc. 5000 for six consecutive years, showcasing our rapid expansion. - Comprehensive Training: Access extensive online training and ongoing mentorship from industry experts. - Exclusive Benefits: Enjoy performance-based training incentives, daily commission payouts, and annual, all-expenses-paid incentive trips. - Work-Life Balance: Benefit from the flexibility of working from home and setting your own schedule. Primary Responsibilities: - Client Engagement: Foster and maintain strong client relationships through effective communication. - Virtual Presentations: Deliver impactful virtual demonstrations of our products. - Sales Goals: Work towards achieving both individual and team sales targets. - Value Proposition: Clearly articulate the benefits and value of our products to prospective clients. - Lead Management: Engage with warm leads and guide them through the sales process. - Sales Documentation: Maintain accurate and detailed records of all sales activities. Ideal Candidate: - Relationship Builder: Enjoys interacting with clients and establishing meaningful connections. - Self-Starter: Driven to succeed with minimal supervision. - Positive Attitude: Maintains optimism and enthusiasm, especially in sales environments. Additional Benefits: - Remote Flexibility: Customize your home office environment to suit your needs. - Quality Leads: Focus on closing deals with access to high-quality leads. - Robust Support: Receive comprehensive training on our products and effective sales techniques. - Health Benefits: Access to life insurance and a comprehensive healthcare exchange covering medical, dental, and vision needs. Apply Now! If you're ambitious, motivated, and eager to advance your career, submit your resume today. We look forward to welcoming you to our dynamic team and supporting your professional growth. Disclaimer: This is a 1099 independent contractor commission-based role with unlimited earning potential. International candidates are not eligible for this position. You'll be offering financial products like Indexed Universal Life (IUL), annuities, life insurance, and more to individuals seeking further details.

United States
$100K - $200K / year
Job Closed
SureGuard logo

Remote Customer Sales Representatives

SureGuard

This is a 1099 independent contractor commission-based role with unlimited earning potential. International candidates are not eligible for this position. You'll be offering financial products like Indexed Universal Life (IUL), annuities, life insurance, and more to individuals seeking further details.

Sales98 days ago
OtherRemoteTeam 11-50

Remote Client Sales Representative - Accelerate Your Career with Us! Are you a driven individual looking for a flexible and rewarding sales career? Join our team as a Client Sales Representative and leverage our exceptional company culture, rapid growth opportunities, and extensive support to excel in the comfort of your home office. Why Choose Us? - Exceptional Culture: Recognized for our outstanding company culture by Entrepreneur Magazine and highly rated on Glassdoor and Indeed. - Full-time opportunity offering consistent hours, stable income potential, and long-term career growth within a supportive remote environment. - Steady Growth: Listed on the Inc. 5000 for six consecutive years, showcasing our rapid expansion. - Comprehensive Training: Access extensive online training and ongoing mentorship from industry experts. - Exclusive Benefits: Enjoy performance-based training incentives, daily commission payouts, and annual, all-expenses-paid incentive trips. - Work-Life Balance: Benefit from the flexibility of working from home and setting your own schedule. Primary Responsibilities: - Client Engagement: Foster and maintain strong client relationships through effective communication. - Virtual Presentations: Deliver impactful virtual demonstrations of our products. - Sales Goals: Work towards achieving both individual and team sales targets. - Value Proposition: Clearly articulate the benefits and value of our products to prospective clients. - Lead Management: Engage with warm leads and guide them through the sales process. - Sales Documentation: Maintain accurate and detailed records of all sales activities. Ideal Candidate: - Relationship Builder: Enjoys interacting with clients and establishing meaningful connections. - Self-Starter: Driven to succeed with minimal supervision. - Positive Attitude: Maintains optimism and enthusiasm, especially in sales environments. Additional Benefits: - Remote Flexibility: Customize your home office environment to suit your needs. - Quality Leads: Focus on closing deals with access to high-quality leads. - Robust Support: Receive comprehensive training on our products and effective sales techniques. - Health Benefits: Access to life insurance and a comprehensive healthcare exchange covering medical, dental, and vision needs. Apply Now! If you're ambitious, motivated, and eager to advance your career, submit your resume today. We look forward to welcoming you to our dynamic team and supporting your professional growth. Disclaimer: This is a 1099 independent contractor commission-based role with unlimited earning potential. International candidates are not eligible for this position. You'll be offering financial products like Indexed Universal Life (IUL), annuities, life insurance, and more to individuals seeking further details.

United States
$100K - $200K / year
Job Closed
83BAR logo

RN - Healthcare Sales

83BAR

83bar is redefining patient recruitment, engagement, and journey management. We deliver the right patient, at the right time, to the right place for clinical trials and commercially approved medical devices and diagnostics. We push patient recruitment further, faster, and provide insights, analysis, and oversight using our patient activation capabilities. The result? Qualified, informed, and high-intent patients for your clinical trial, drug, diagnostic, or device.

Sales98 days ago
OtherRemoteTeam 51-200

REMOTE RN: RN - Health Care Sales / Clinical Sales Specialist This is a remote, work-from-home, part-time position. We are currently only accepting applications from medical professionals. About the Company: Since 2015 we have been working with cutting-edge companies providing innovative care solutions to complex medical conditions. We have employees located across the United States. Through our online marketing ads, we find people in need of medical procedures or treatments, who ask for more information, we then call them to provide the information they need to make and attend an appointment with one of our partner doctors. Our clients aren't your typical healthcare companies.. We work with creative companies with innovative solutions who are trying to help people solve their health issues in new and innovative ways; That's where we come in! We use cutting-edge lead generation and sales automation to help consumers find our clients. Here are a few examples of the companies we work with: - A DNA lab testing company that helps people discover if they are at risk of hereditary cancers. - A services company that treats people with prediabetes and prevents them from developing Type II diabetes. One-third of adults have prediabetes! - A medical device company that helps women who have been struggling with bladder control for years. Responsibilities: As a Clinical Sales Specialist, you will use your medical knowledge and patient care experience to guide those who have reached out to 83bar for information about the care solution that they are looking for. We never cold call, so you will be contacting only those who have expressed an interest in the services that our clients provide and helping them to take the next step in their journey towards a healthier future. We’ve custom-built a web-based system that allows you to access what you need from the convenience of home. You just need your laptop (that meets internet speed requirements) with access to high-speed Internet and a quiet, private space to work. We are currently hiring for part-time positions and we are looking for applicants available to work shifts between 8:00 am and 7:00 pm CST Monday through Friday and 10:00 am to 5:00 pm CST on Saturday. We are seeking applicants with healthcare experience and the empathy required to successfully connect with the people we are reaching out to help and educate them about the life-changing services our clients have to offer. Requirements: - Fluent in English. - Healthcare background. - Available minimum of 20 hours per week. - Able to commit to a set schedule. - Access to high-speed internet. - Self-motivated and adaptable. - Highly Empathetic. - Prior experience in sales/customer service preferred. - Strong communication skills. Perks: - Customizable schedule. - Work-from-home flexibility. - Competitive compensation at $31.00/ hour. - Individual agent quarterly performance incentive plan. - Strong and supportive contact center culture. - 401k with company matching. Application Process: If you are interested in this exciting opportunity, please submit your resume! If your work experience aligns with the job responsibilities, someone on our HR Team will reach out to you with the next steps in our application process! Please do not contact our office directly with inquiries on application status. We are fortunate to have many qualified applicants apply and will only be able to contact those who have been selected for an interview. We appreciate your time and thank you for considering 83bar in your employment search. We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

United States
Job Closed
SureGuard logo

Remote Customer Sales Representatives

SureGuard

This is a 1099 independent contractor commission-based role with unlimited earning potential. International candidates are not eligible for this position. You'll be offering financial products like Indexed Universal Life (IUL), annuities, life insurance, and more to individuals seeking further details.

Sales98 days ago
OtherRemoteTeam 11-50

Remote Client Sales Representative - Accelerate Your Career with Us! Are you a driven individual looking for a flexible and rewarding sales career? Join our team as a Client Sales Representative and leverage our exceptional company culture, rapid growth opportunities, and extensive support to excel in the comfort of your home office. Why Choose Us? - Exceptional Culture: Recognized for our outstanding company culture by Entrepreneur Magazine and highly rated on Glassdoor and Indeed. - Full-time opportunity offering consistent hours, stable income potential, and long-term career growth within a supportive remote environment. - Steady Growth: Listed on the Inc. 5000 for six consecutive years, showcasing our rapid expansion. - Comprehensive Training: Access extensive online training and ongoing mentorship from industry experts. - Exclusive Benefits: Enjoy performance-based training incentives, daily commission payouts, and annual, all-expenses-paid incentive trips. - Work-Life Balance: Benefit from the flexibility of working from home and setting your own schedule. Primary Responsibilities: - Client Engagement: Foster and maintain strong client relationships through effective communication. - Virtual Presentations: Deliver impactful virtual demonstrations of our products. - Sales Goals: Work towards achieving both individual and team sales targets. - Value Proposition: Clearly articulate the benefits and value of our products to prospective clients. - Lead Management: Engage with warm leads and guide them through the sales process. - Sales Documentation: Maintain accurate and detailed records of all sales activities. Ideal Candidate: - Relationship Builder: Enjoys interacting with clients and establishing meaningful connections. - Self-Starter: Driven to succeed with minimal supervision. - Positive Attitude: Maintains optimism and enthusiasm, especially in sales environments. Additional Benefits: - Remote Flexibility: Customize your home office environment to suit your needs. - Quality Leads: Focus on closing deals with access to high-quality leads. - Robust Support: Receive comprehensive training on our products and effective sales techniques. - Health Benefits: Access to life insurance and a comprehensive healthcare exchange covering medical, dental, and vision needs. Apply Now! If you're ambitious, motivated, and eager to advance your career, submit your resume today. We look forward to welcoming you to our dynamic team and supporting your professional growth. Disclaimer: This is a 1099 independent contractor commission-based role with unlimited earning potential. International candidates are not eligible for this position. You'll be offering financial products like Indexed Universal Life (IUL), annuities, life insurance, and more to individuals seeking further details.

United States
$100K - $200K / year
Job Closed