Medical Claims Review Senior Analyst
cigna· IN1 Cigna Health Solutions India Private Limited
About this role
Medical Claims Review Senior Analyst/Clinical supervisor – Complex Claim Unit
Provides clinical review expertise for high dollar and complex claims, including facility and professional bills. Provides cost containment services by identifying coding and billing errors and insuring application of Medical and Reimbursement Policies. Additionally identifies cases for potential fraud and abuse and makes referrals.
Major Job Responsibilities
- Evaluates medical information against criteria, benefit plan, coverage policies and determines necessity for procedure and refers to Medical Director if criteria are not met
- Evaluate itemized bills against reimbursement policies
- Adheres to quality assurance standards
- Serves as a resource to facilitate understanding of products
- Handles some escalated cases; secures supervisory assistance with problem solving and decision making
- Advises supervisory staff of any concerns or complaints expressed by Health Care Professionals
- Utilizes effective communication, courtesy and professionalism in all interactions, both internally and externally
- Performs additional unit duties below as appropriate:
- Participate on special projects.
- Perform random or focused reviews as required.
- Support and assist with training and precepting as required
- Analyze clinical information
- Perform claim reviews with focus on coding and billing errors
- Identify and refer cases for possible fraud/abuse or questionable billing practices to the appropriate matrix partners
- Handle multiple products and benefit plans
- Works under moderate direct supervision
Qualifications
- MBBS
- Maintain active Medical as required by state and company guidelines
- Clinical experience in hospital/clinic for 3 or more years
- Team player
- Flexible/Adaptable
- Excellent time management, organizational, and research skills
- Experience with MS Office Suite (Outlook, Excel, Access, SharePoint)
Preferred Qualifications
- Utilization Review or Claim Review experience in Health insurance
- Knowledge of the Principles of Health Care Reimbursement
Key Skills and Competencies
- Strong background in quantitative decision making, ability to drive business/operations metrics
- Metrics-driven. Able to translate strategy into measurable operational goals and objectives. Disciplined in assessing performance and addressing problems.
- Good communication and strong interpersonal skills.
- Highly organized, structured & proactive.
- Good inter-cultural skills & Exposure to global work environment.
- Good time management skills - meet tight timelines and manage ad hoc deliverables, if any.
About The Cigna Group
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.Frequently Asked Questions
Is the salary disclosed for the Medical Claims Review Senior Analyst position at cigna?
The salary for this Medical Claims Review Senior Analyst role at cigna is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Medical Claims Review Senior Analyst position at cigna located?
This Medical Claims Review Senior Analyst role at cigna is based in Bengaluru, India. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Medical Claims Review Senior Analyst role at cigna full-time or part-time?
This is listed as a Full time position. It is posted as a Medical Claims Review Senior Analyst role in the IN1 Cigna Health Solutions India Private Limited department at cigna.
Which team or department does the Medical Claims Review Senior Analyst at cigna belong to?
This Medical Claims Review Senior Analyst position is part of the IN1 Cigna Health Solutions India Private Limited department at cigna. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Medical Claims Review Senior Analyst position at cigna?
Click the "Apply Now" button on this page. You will be redirected to cigna's official application portal hosted on workday where you can submit your application directly.
When was the Medical Claims Review Senior Analyst job at cigna posted?
This Medical Claims Review Senior Analyst position at cigna was posted on Sep 2, 2026. Apply as soon as possible — early applications are often reviewed first.
Medical Claims Review Senior Analyst
cigna
You'll be redirected to cigna's official application page on Workday.