Healthcare · Full-time
Direct employerClaims Representative- Cigna Healthcare

Published by employer
About this role
This plain-English summary was prepared by work.ke from the original advert. Confirm all details on the source before applying.
Role overview
Cigna Healthcare is hiring a Claims Representative based at Kenya One Africa Place. This full-time role suits individuals with a degree or diploma who want to work in health insurance claims and customer service.
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What you will do
- Adjudicate international medical, dental, and vision claims according to policy terms to meet productivity and quality goals.
- Monitor high-cost claims and notify relevant parties.
- Ensure claims are processed within required timeframes and report delays to the Supervisor.
- Respond to enquiries about plan design, eligibility, and claims status, aiming for first call resolution.
- Communicate effectively with internal and external customers to resolve issues.
- Identify and suggest process improvements to senior team members.
- Support team members to help achieve team goals.
- Perform other ad hoc tasks as required by the business.
Requirements
- Degree or diploma in a relevant field.
- Customer-focused with problem-solving skills.
- Ability to meet or exceed targets and handle multiple priorities.
- Proficient in Microsoft Office applications.
- Good command of English and arithmetic.
- Experience in medical administration, claims, or contact centre environment is advantageous.
- Excellent attention to detail and accuracy.
- Strong interpersonal and communication skills, both verbal and written.
- Ability to work independently and proactively recommend process improvements.
- Organisational skills to prioritise and manage workflow.
- Ability to exercise judgement.
How to apply
Apply through the employer's official contact by submitting a CV. The closing date for applications is Wednesday, 4 November 2026.
