Claims Representative

7 days ago

Kuala Lumpur, Malaysia The Cigna Group Full time

Cigna is one of the world’s leading providers of health care, expatriate employee benefits, life, accidental and supplemental health insurance. Headquartered in the US and listed in NYSE, the Company operates in countries across the Americas, Europe, Africa and Asia Pacific.

Cigna Global Health Benefits (CGHB) is an integral part of Cigna's growing international businesses. Product types include: Medical, Dental, Vision, Life, AD&D, Disability, Travel, etc., sold to groups and individuals. We have approximately 1 million medical members around the world.

**YOUR JOB**

**Scope**

Critical analysis and processing of claims for medical expenses within the fixed turn around time.

**Job content**
- Claims processing_
- Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality.
- 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 Team Leader 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 Team Leader.
- Raising problems or sensitivities with your superior.
- Participating actively in an agreeable and amicable atmosphere.

**PROFILE**

**Education Level**
- Bachelor Degree or similar by experience

**Specific Knowledge**
- Active knowledge of English
- Passive knowledge of other languages
- Policies coverage
- Medical terminology
- Use of necessary reference works

**Skills**
- Skillful in taking decisions; takes the right action on allocated files based on the available information.
- Skilful with numbers: likes to work with numbers.
- 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.
- 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.

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