IOH Member Claims Representative
AI job insight
Cigna is seeking an IOH Member Claims Representative in Nairobi to adjudicate medical, dental and vision claims and assess reimbursements. The role requires a diploma or relevant degree, strong analytical and numerical skills, and clear English; French proficiency and prior medical claims experience are advantageous.
- Adjudicates medical, dental and vision claims against policy terms and reimbursement agreements.
- Uses computerized claims systems to assess, code and calculate reimbursements.
- Manages complex cases, turnaround times, enquiries and stakeholder communications.
Similar jobs
More roles you may want to review before you leave.AI summary
Cigna is seeking an IOH Member Claims Representative in Nairobi to adjudicate medical, dental and vision claims and assess reimbursements. The role requires a diploma or relevant degree, strong analytical and numerical skills, and clear English; French proficiency and prior medical claims experience are advantageous.
- Adjudicates medical, dental and vision claims against policy terms and reimbursement agreements.
- Uses computerized claims systems to assess, code and calculate reimbursements.
- Manages complex cases, turnaround times, enquiries and stakeholder communications.
- A diploma or degree in a relevant field is required; prior claims experience is advantageous.
- Strong English is required, while French proficiency is an added advantage.
- The listed application deadline is 29 October 2026.
AI job guide
Use this guide to check salary signals, requirements, documents, application steps and safety before you apply.
AI salary guide
Not enough public dataNot enough public salary data is available for this exact role. Before applying, prepare to ask about gross pay, benefits, contract length, probation period, transport and any allowances.
Can you qualify for this role?
- UnclearRelated work experienceThe text mentions experience, but the exact level should be confirmed at source.
- RequiredEducation or certification mentioned in the postThe captured text mentions education, a diploma, certificate, or licence.
- PreferredPractical evidence in internship, Claims representative, Medical claimsThe tags and summary point to skills connected with this role.
- RequiredAvailability to work in NairobiThe vacancy is associated with this location.
- UnclearComfort with the Other contract termsConfirm hours, duration, probation and benefits at the original source.
Documents to prepare
- Likely requiredUpdated CV
- Role specificCover letter or short employer message
- OptionalProfessional references
- Role specificAcademic or professional certificates
- VerifyID or passport only after verifying the employer
Application tips for this job
- Place your strongest IOH Member Claims Representative evidence in the first half of your CV.
- In your cover letter or employer message, connect your experience to Cigna and the role in Nairobi.
- Add concrete examples related to internship, Claims representative, Medical claims, ideally with measurable outcomes or clear responsibilities.
- Follow the instructions from Job in Kenya; avoid sending documents to unofficial contacts or copied links.
- Confirm the deadline, interview location and employer contact before sharing personal documents.
- Plan to submit before the listed deadline: 2026-10-29.
Source and safety check
- Job in Kenya
- Original source link available
- Application method is clear
- Deadline is available: 2026-10-29
- No major risk signal was detected in the captured text.
Never pay for interviews, shortlisting, medical checks, uniforms, or job placement. Confirm every application at the original source before sharing personal documents. Report suspicious listing.
Interview preparation
- What experience makes you a strong fit for this IOH Member Claims Representative role in internship, Claims representative?
- How have you handled responsibilities similar to those in this job post?
- Are you available to work in Nairobi under the listed contract or schedule?
- Prepare examples with clear responsibilities, tools used and measurable outcomes.
- Review the source and research Cigna before the interview.
Ask what the first priorities will be in the role and how success will be measured.
Similar jobs to consider
Use AI to apply better
After confirming the original source, use Career Assistant to check role fit, tailor your CV and prepare a cover letter or employer message.
Original source description
IOH Member Claims Representative
YOUR JOB
As Claims Representative you analyze claims in respect of client medical costs.
You adjudicate medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
You analyze reimbursements according to the contract agreements and assess, code and calculate them using a computerized claims processing system.
You pass communications to the communication team to solve or preempt any possible issues with your stakeholders.
Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your supervisor when this is not achievable.
You take responsibility/ownership of complex cases. You handle them accurately and with the personal attention that is required.
You keep your knowledge up to date with respect to the medical information necessary for handling claims and you take part in trainings to ensure you are up to date with policies, processes and other required information.
You are attentive to inaccuracies in the files and communicate them to your team leader/departmental head.
Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible.
Carry out other adhoc tasks as required in meeting business needs.
YOUR PROFILE
Diploma or degree in a relevant field.
Previous experience handling medical claims within a health insurance or healthcare provider environment is an added advantage.
Strong working knowledge of English, with confidence communicating with both internal and external stakeholders.
French language proficiency is an added advantage.
Previous experience in an analytical role with strong numerical ability with a high level of accuracy and attention to detail is desirable.
Good analytical and problem-solving skills, with the ability to review information and make sound decisions.
Customer-focused mindset, with the ability to balance accuracy, service and operational requirements.
Ability to work independently, take ownership of tasks and escalate appropriately when required.
Ability to adapt quickly to changing processes, priorities and systems.
High level of integrity and discretion when handling confidential and sensitive medical or customer information.
Proactive and collaborative approach, with a willingness to share knowledge and best practices with colleagues.
Comfortable learning and working with computer-based applications and claims processing systems.
Method of application
- If you are interested and qualified, kindly submit your application via the link provided below,
- https://cigna.wd5.myworkdayjobs.com/en-US/cignacareers/job/Kenya-One-Africa-Place/IOH-Member-Claims-Representative---Cigna-Healthcare_26012973?Location_Country=9e684fd7be1e469d9ee955a4c3b754be&utm_source=Jobinkenya
- Deadline 29 October 2026