About this role
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 turn around 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 customer issues.
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.
Experience Required:
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 or education in medical or life sciences, claims environments, or contact center settings is advantageous but not essential.
Skills:
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 judgment.
About The Cigna Group
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Other facts
About The Cigna Group
The Cigna Group is a global health company committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health.
The Cigna Group includes products and services marketed under Cigna Healthcare, Evernorth Health Services or its subsidiaries. The Cigna Group maintains sales capabilities in more than 30 countries and jurisdictions, and has more than 190 million customer relationships around the world.
What you'll do
- The Claims Associate Representative is responsible for adjudicating international medical, dental, and vision claims according to policy terms. They must monitor claims, respond to inquiries, and support team goals while identifying process improvements.
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