Job description
Role Overview
Claims Representative at Cigna, Middle East. This role is at the heart of Cigna's claims processing operation, responsible for organizing and tracking workflow daily to facilitate consistent attainment of turnaround times and other critical success factors for Claims.
Company Overview
The Cigna Group is dedicated to improving the health and vitality of those it serves. Through its divisions Cigna Healthcare and Evernorth Health Services, the organization is committed to enhancing the lives of its clients, customers and patients. Cigna KSA has recently been certified as a Great Place to Work.
Role Purpose
The position holder will organize and track claims workflow, respond to queries from multiple in-house and external sources, and free the Cigna Claims Team to focus exclusively on attaining daily targets. The role requires strong organization, efficiency, accuracy and interpersonal skills, with a preferably appreciation of medical terms.
Key Responsibilities
Claims Receipt and Processing
- Take receipt of submitted claim batches from providers and individual claims direct from members.
- Log and file claims received for tracking, planning and processing purposes.
- Scan and image hard-copy claims received.
- Assemble processing batches and assign to team members.
Operations and Workflow Management
- Conduct operations planning; compile processing schedules for the Claims Team.
- Accept finalized claims; update status in systems and trackers as required.
Stakeholder Communication and Query Resolution
- Reach out to providers and members; source additional information as needed to finalize claims.
- Resolve inbound queries from providers and members; maximize first-time contact resolution.
Reporting
- Deliver regular claims status reporting as specified.
Qualifications & Experience
- One year's experience performing a similar role combining administration and stakeholder contact.
- Experience of working for an international company preferred but not essential.
- Previous claims or insurance experience preferred but not essential.
- Broad awareness of medical terminology advantageous.
Skills & Competencies
- Excellent organizational skills; capable of following and contributing to agreed procedure.
- Strong administration awareness and experience, essential.
- Strong skills in Microsoft Office applications, essential.
- First-class written and verbal communication skills, essential.
- Ability to communicate across a diverse population, essential.
- Capable of working independently or as part of a team.
- Good time management; ability to work to tight deadlines.
- Flexible and adaptable approach; capable of working in a fast-paced environment.
- Passion for achieving agreed objectives.
Additional Information
- Contract type: Hybrid mode.
- Work schedule: Flexible, as per KSA Labor Law.
- Benefits: International exposure; pleasant work environment.