Claims Senior Representative

About this role

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Skills you'll use

What you'll do

• Operational Processing & Complex Case Handling
• Complete both standard and higher‑complexity back‑office tasks in line with SOPs and business rules e.g high cost authorisation.
• Independently handle exceptions, unclear scenarios, and non‑routine cases within defined authority limits.
• Review, investigate, and resolve aged, escalated, or priority cases.
• Ensure all system updates, documentation, and case notes are accurate, complete, and audit‑ready.
• Quality, Accuracy & Compliance
• Conduct peer reviews and quality checks as assigned by team leads or supervisors.
• Identify and flag risk, recurring errors, procedural gaps, or accuracy risks and escalate promptly.
• Support compliance by maintaining strict adherence to regulatory requirements, audit, and data‑protection requirements.
• Promote high‑quality processing through consistent modelling of best‑practice standards.

About Cigna

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