Claims Representative

3 weeks ago

Kuala Lumpur, Kuala Lumpur, Malaysia The Cigna Group Full time
The job profile for this position is Claims Senior Representative A, which is a Band 2 Professional Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

  • Adjudicate international medical, dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
  • Identify claims where further information is required working towards SLA and timescales.
  • 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 to meet client SLA's.
  • Identify potential process improvements and make recommendations.
  • Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first contact resolution where possible.
  • Actively support other team members and provide resource to enable all team goals to be achieved.
  • Manage customer instructions through the development of high quality interpersonal skills.
  • Achieve personal and team productivity and quality goals.
  • Ensure work is prioritized effectively.
  • Work across APAC businesses and closely with other departments in line with service needs.
  • Interface effectively with internal and external businesses to resolve customer issues.
  • Carry out other adhoc tasks as required meeting business needs.
  • Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
  • Flex between all of the above activities based on current customer demand.
  • Flex your working shift based on current customer demand.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

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