Cigna is a global health service company dedicated to helping people improve their health, well-being, and sense of security. With a workforce of nearly 40,000 employees serving over 80 million customers worldwide, Cigna is a leader in the international health insurance space. This role is within the international division, focusing on the needs of international members.
Role Purpose
As a Claims Representative, you will be responsible for analyzing and adjudicating medical, dental, and vision insurance claims. Your primary objective is to ensure that reimbursements are processed accurately and efficiently according to policy terms and conditions while maintaining high standards of quality and customer service.
Key Responsibilities
Analyze medical, dental, and vision claims regarding client medical costs.
Adjudicate claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
Analyze reimbursements according to contract agreements; assess, code, and calculate them using a computerized claims processing system.
Coordinate with the communication team to solve or preempt any possible issues with stakeholders.
Monitor turnaround times to ensure claims are settled within required timescales, highlighting potential delays to supervisors.
Take ownership of complex cases, handling them with accuracy and personal attention.
Maintain up-to-date knowledge of medical information necessary for handling claims.
Participate in training to ensure alignment with current policies, processes, and required information.
Identify and communicate inaccuracies in files to the team leader or departmental head.
Respond to enquiries regarding plan design, eligibility, and claims status within committed timeframes, aiming for first-call resolution.
Perform other ad-hoc tasks as required to meet business needs.
Requirements and Qualifications
Education: Diploma or Bachelor's degree in a related field.
Experience: A first experience in analytical work is considered a plus. Entry-level candidates with a strong aptitude for numbers are encouraged to apply.
Language: Proficiency in the French language is an added advantage.
Technical Skills: Knowledge of claims processing and familiarity with computer applications.
Attributes: Promptness, precision, high attention to detail, and the ability to work meticulously.
Soft Skills: Ability to work individually and make correct decisions guided by customer centricity; flexibility to adapt to changing work processes; awareness of data sensitivity and confidentiality; proactive team player.
How to Apply
Interested and qualified candidates should apply online through the official Cigna recruitment portal. Use the following link to proceed with your application: Apply for Claims Representative - IOH Member Claims
How to Apply
Interested and qualified candidates should apply online through the Cigna recruitment portal by clicking the following link: Apply Here. You will be redirected to the official Cigna Workday jobs page (cigna.wd5.myworkdayjobs.com) to complete your application.
