Claims Representative- Cigna Healthcare

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: 

• Degree or diploma in a relevant field
• Customer focused with ability to identify and solve problems.
• Ability to meet/exceed targets and manage multiple priorities. 
• Proficient in Microsoft Office applications. 
• English and Arithmetic proficiency required. 
• Experience in medical administration, claims environment or Contact Centre environment is advantageous. 

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 judgement.