Vacancies at Cigna

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.

What are your 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.
• Process claims from Europe and Africa clusters in different languages.

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. 
• Preferred if English and Arithmetic qualification gained. 
• Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. 
• Additional language will be an added advantage.

KEY COMPETENTIES: 

• Diploma or Bachelor's degree in Business related field
• 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 organize, prioritize and manage workflow to meet individual and team requirements. 
• Ability to exercise judgement.

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YOUR JOB

As a Claims Representative you will be handling multiplatform processing and adjusting of claims. You will report directly into the supervisor and will work closely with your peers in the same as well as others locations across the globe. Key to the role will be critical analysis, processing and adjusting of claims for medical expenses within the fixed turn-around time and with high the established quality standards. Your role includes:

Job Profile:

Claims processing

• Assessing, processing and adjusting of claims for medical expenses while always bearing in mind the importance of medical confidentiality.
• Accurate data input to the different systems applications.
• Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods.
• Following up his/her own workload (volume and timing): keeping an eye on chronology and processing time of the work volume and taking suitable actions.
• Participate efficiently in processing the flow of claims: inform the Supervisor about claims lacking clarity and about possible ways of optimizing the processes.
• A sustained effort towards high-quality claims handling, accurate reimbursements and fast transactions are important motivators.

In relation to other positions:

• Providing accurate communication about a dossier to the interested internal employee.
• Tracking irregularities in procedures and highlighting these to the Supervisor.
• Raising problems or sensitivities with your supervisor.
• Participating actively in an agreeable and amicable atmosphere.
• Any other duty as assigned by the supervisor.

YOUR PROFILE/SKILLS

Education Level

• Diploma or Bachelor Degree in Business related field

Specific Knowledge

• Active knowledge of English
• Active/passive knowledge of other languages is an added advantage (French, Portuguese, Spanish, German, Arabic languages)

Skills

• Skillful in taking decisions: takes the right action on allocated files based on the available information.
• Skillful with numbers: likes to work with numbers.
• Flexible: is able to adapt to the changes easily;
• Multitasking: works easily in different systems at the same time;
• Accurate: works accurately on the input of data, aims to work faultlessly.
• Discipline: pays attention to procedures, agreements and document flows.
• Efficient: finds a good balance between quality and quantity.
• Team player: Able to work in a team.
• Skillful with computer programs: readily learns the ropes in the use of current office applications and own Cigna International systems.
• Discreet: works discreetly with confidential (medical) information.