Technical Coaching Lead Representative - Centralized Overpayment Recovery - Remote

Bring your claim expertise and leadership strengths to help deliver accurate and timely recoveries. In this role, you’ll strengthen technical capability, elevate quality outcomes, and help partners solve root-cause issues—while building a culture of learning, clarity, and continuous improvement.

Responsibilities

• Increase claim accuracy and consistency by coaching processors on workflows, tools, and best practices.
• Enable faster, more confident decisions by providing timely, high-quality answers to technical processing questions.
• Deliver targeted learning (1:1 and group) that grows capability across routine and complex Centralized Overpayment Recovery scenarios.
• Lead or support training sessions to roll out process changes, new guidance, and refresher content.
• Use Service Quality Review Meeting (SQRM) insights to identify trends, isolate root causes, and drive corrective action.
• Partner with supervisors and cross-site teams (including GSP partners) to improve quality/KPIs through huddles, calibrations, and feedback loops.
• Advance continuous improvement by recommending and implementing process, job aid, or control enhancements that reduce rework and improve resolution quality.
• Own and report on quality outcomes for the supported team, highlighting risks, wins, and next best actions.

Qualifications - Required

• High School Diploma or G.E.D.
• 2+ years of hands-on claim processing experience, including Centralized Overpayment Recovery (or closely related recovery work).
• Strong working knowledge of claim systems and workflows (e.g., Proclaim, Facets, and C-Funds for refunds/recoupments).
• Track record of meeting or exceeding key performance metrics in your current or most recent role.
• Customer-focused approach with the ability to balance accuracy, speed, and service.
• Sound judgment, critical thinking, and accountability for decision outcomes.
• Strong problem-solving skills and the ability to use available tools and resources to reach accurate final resolution.
• Clear communication skills (written and verbal), including the ability to explain technical topics in simple terms.
• Ability to teach, coach, and support others across a range of claim complexities.
• Comfort collaborating with teams in multiple locations (in-office and work-from-home partners).

Qualifications - Preferred

• Experience serving as a Team SME or New Hire Class SME
• OPR Experience
• Experience partnering with quality coaching and audit teams to drive KPI and accuracy improvements.
• Proficiency with Microsoft Word, Excel, PowerPoint, Outlook, and virtual meeting tools (e.g., WebEx or similar).

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 22 - 33 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email <a target="_blank" href="mailto:seeyourself@thecignagroup.com">seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.