Claims Officer - Cigna Healthcare

About the role

Cigna Healthcare is hiring a Claims Associate Analyst within its Middle East Claims Operations team. You will support the accurate and timely assessment of medical reimbursement and provider claims, reviewing medical information, policy benefits and supporting documentation so that claims are assessed fairly, consistently and accurately. The role suits an analytical, detail-oriented healthcare-qualified professional interested in health insurance and claims operations.

Key responsibilities

• Assess member reimbursement and provider claims accurately, within agreed quality, productivity and turnaround-time standards.
• Review claim forms, medical reports, prescriptions, invoices, receipts, investigation results, proof of payment and other supporting documentation.
• Validate member eligibility, coverage, dates of service, diagnoses, procedures, coding, billed amounts, provider details and clinical evidence.
• Apply policy terms, benefits, limits, exclusions, clinical guidelines, pricing rules, deductibles, co-insurance and member-share requirements.
• Assess medical necessity and identify incomplete documentation, duplicate or inconsistent billing, coding concerns, non-covered services and unusual billing patterns.
• Maintain clear, complete and auditable notes for each claim decision, request additional information when needed and escalate complex, high-value or disputed cases.
• Explain claim decisions and documentation requirements clearly to internal stakeholders and handle confidential information in line with Cigna's procedures and privacy standards.

Required profile

• A recognised healthcare qualification such as BDS, MBBS, BAMS, BHMS or equivalent medical degree, Bachelor of Nursing, or another relevant clinical or allied-health qualification.
• Applications welcome from healthcare-qualified candidates starting their careers, as well as those with one to two years of experience in medical claims, preauthorisation, medical billing, provider operations or health insurance.
• Nice to have: experience with reimbursement or provider claims, international or Middle East medical claims, and previous exposure to healthcare or health insurance operations.

Required skills

• Sound knowledge of medical terminology, diagnoses, procedures, treatment pathways and clinical documentation.
• Basic understanding of ICD, CPT, health insurance benefits, exclusions, deductibles and co-insurance, with a willingness to develop further.
• Ability to review and interpret medical records and claim documentation, and to adapt to claims-processing systems and tools.
• Proficiency in Microsoft Office applications.
• Strong written and verbal communication in English, analytical and numerical skills, attention to detail, and ability to meet deadlines.

What we offer

• Competitive salary.
• Multicultural and hybrid working environment.
• Private Medical Insurance.
• Employee wellbeing benefits.
• Educational development program.