Claims Senior Representative

Cigna — Bengaluru, India

ROLE SUMMARY As a Claims Senior Representative , you will play a critical role in delivering accurate, timely, and high‑quality operational processing across your function (e.g., Claims/Adjustments, Eligibility, Administration, Customer Service Support, Client Setup and Subrogation). You will handle higher‑complexity cases, support workflow management, provide guidance to colleagues, and help drive quality, accuracy, and operational consistency. Acting as a reliable escalation point for Band 1 analysts, you contribute directly to operational excellence by applying deeper process knowledge, problem‑solving capability, and proactive risk identification. This role keeps operations running smoothly by ensuring work is completed right the first time, supporting continuous improvement, and helping maintain control, compliance, and strong service outcomes. KEY RESPONSIBILITIES 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. Process Adherence & Continuous Improvement Interpret SOPs in complex or ambiguous situations and support colleagues in understanding them. Provide actionable feedback on recurring issues, process inefficiencies, or unclear guidance. Contribute t

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