Latest Recruitment at Cigna

Role overview

To Focus on achieving various business objectives to ensure smooth and efficient functioning of the Operations units.

The incumbent will:

• Operational Efficiency: Streamlining processes and workflows to enhance overall efficiency and reduce operational costs.
• Regulatory Compliance: Ensuring that all operations adhere to industry regulations and compliance standards, minimizing legal risks.
• Customer Satisfaction: Implementing strategies to improve customer experiences, claims processing, and communication to enhance overall satisfaction
• Risk Management: Identifying and mitigating operational risks to safeguard the company's financial health and reputation.
• Team Management: Building and leading effective teams, fostering a positive work environment, and ensuring staff is well-trained and motivated
• Cost Management: Implementing cost-effective measures without compromising quality to maximize profitability.
• Claims Processing Optimization: Streamlining the claims process to expedite settlements and improve customer satisfaction.
• Strategic Planning: Collaborating with other departments to contribute to the overall strategic goals and growth of the insurance company.

Responsibilities

• Overseeing day-to-day activities, ensuring regulatory compliance, managing staff, and implementing strategic initiatives to enhance operational efficiency.
• Supervise and lead the policy processing team to ensure efficiency in daily operations.
• Lead, motivate, and support the team within a time-sensitive and demanding environment, including career development plans for direct reports and problem resolution.
• Provides operational support by preparing and reviewing of operational plans, monitoring progression and service levels and reporting to the Head of Operations.
• Ensuring healthy claims flow and backlogs to avoid service interruptions
• Drive operational efficiency and implement quality checks to ensure enhanced outputs and maintain client experience
• NPS improvement through implementing action plans
• Execute strategic initiatives both through organizational alignment and matrix partner management to produce profitable growth. For key projects (such as strategy development or investment opportunities), position personally drives projects with senior business and functional leadership.
• Works with sales & marketing teams and partners with Operations management teams on escalated issues and issue resolution. Removes barriers to ensure client escalations are handled timely and accurately.
• Participate in monthly/quarterly meetings with client(s) as requested or when needed by the head of operations.
• Business Continuity Plan: maintains system disaster recovery plan.
• Liaise with other departments on new initiatives and system change and Maintain constant communication with managers, staff, and vendors to ensure proper operations of the company.
• Implement and maintain quality assurance protocols and Increase the efficiency of existing processes and procedures to enhance the company’s internal capacity
• Ensure that operational activities remain on time and within budget.

EDUCATION/ EXPERIENCE & OTHER REQUIREMENTS

• Bachelor’s Degree required.
• Industry and leadership experience of 5-10 years
• Experience in leading and influencing, in a matrixed environment is critical.

COMPETENCIES:

• Leadership: Ability to lead and inspire teams, fostering a collaborative and productive work environment.
• Strategic Thinking: Capacity to contribute to the development and execution of strategic plans for operational excellence and business growth.
• Analytical Skills: Strong analytical abilities to assess data, identify trends, and make informed decisions for process improvement.
• Communication Skills: Clear and effective communication with team members, other departments, and external stakeholders
• Regulatory and market knowledge: Understanding of insurance regulations and compliance requirements to ensure adherence to industry standards
• Problem Solving: Aptitude for identifying challenges, developing solutions, and implementing effective problem-solving strategies.
• Project Management: Proficiency in managing projects, including planning, execution, and monitoring to achieve desired outcomes.
• Customer Focus: Commitment to enhancing customer experiences through efficient processes and effective communication.
• Team Development: Capability to recruit, train, and develop high-performing teams to achieve operational objectives.
• Adaptability: Flexibility to adapt to changing industry trends, regulations, and business needs

go to method of application »

YOUR JOB

Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims from Healthcare Providers. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles.

Main Duties/Responsibilities:  

• Adjudicate international medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. 
• Monitor and highlight high cost claims and ensure relevant parties are aware. 
• Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. 
• 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. 
• Interface effectively with internal and external customers to resolve Provider issues. 
• Have full ownership of Provider’s Country Cluster assigned.
• Identify potential process improvements and make recommendations to team senior. 
• Actively support other team members and provide resource to enable all team goals to be achieved. 
• Work across European business in line with service needs. 
• Carry out other adhoc tasks as required meeting business needs.

YOUR PROFILE

• Customer focused with ability to identify and solve problems.
• Ability to meet/exceed targets and manage multiple priorities. 
• Proficient in Microsoft Office applications. 
• Experience in medical administration, claims environment or related field.
• Proficiency in English and Spanish or Portuguese preferred.
• A Diploma or degree qualification. 

KEY COMPETENTIES: 

• Must possess excellent attention to detail, with a high level of accuracy. 
• Strong interpersonal skills with good verbal and written communication to internal and external clients. 
• Strong customer focus with ability to identify and solve problems. 
• Ability to work under own initiative and proactive in recommending and implementing process improvements. 
• Ability to organise, prioritise and manage workflow to meet individual and team requirements. 
• Ability to exercise judgement.