Job Description

YOUR JOB

As a Claims Representative you will be part of Provider Services department, handling multiplatform processing and adjusting of provider claims which will be identified through the reconciliation output. 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 content

Claims processing

- Assessing, processing and adjusting provider 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 superior.

- Participating actively in an agreeable and amicable atmosphere.

YOUR PROFILE/SKILLS

Education Level

Bachelor Degree or similar by experience

Specific Knowledge

- Active knowledge of English

- Passive knowledge of other languages is a plus (any European or Asian languages)

- Insurance and medical terminology;

- Use of necessary reference works;

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.

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.

Cigna