Claims Representative (Geh) - Provider Service Organisation At Cigna

Details of the offer

YOUR JOB
Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims from Healthcare Providers. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles.
What are your 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 turnaround 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 Provider issues.
Have full ownership of Provider's Country Cluster assigned.
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.

YOUR PROFILE
Customer focused with ability to identify and solve problems.
Ability to meet/exceed targets and manage multiple priorities.
Proficient in Microsoft Office applications.
Preferred if English and Arithmetic qualification gained.
Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential.

KEY COMPETENTIES:
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 organize, prioritize and manage workflow to meet individual and team requirements.
Ability to exercise judgement.


Nominal Salary: To be agreed

Source: Myjobmag_Co

Job Function:

Requirements

Rda Technologist At Priority Activator Consulting

Lead end-to-end project management for applied research, technology, and innovation initiatives. Oversee sensory evaluation processes for beverages, utilizin...


From Priority Activator Consulting - Nairobi Area

Published a month ago

Advisor, Health Emergencies (Cpcp) At World Health Organization

DESCRIPTION OF DUTIES Under the direct supervision of the PAHO/WHO Representative (PWR)and the general supervision of the Director, Health Emergencies (PHE),...


From Ion - Nairobi Area

Published a month ago

Regional Implementation Officer – Telemedicine Program At Medecins Sans Frontieres (Msf)

The Regional Implementation Officer (RIO) is a Telemedicine services implementer, influencer, and ambassador. This position within the region sets them as th...


From Medecins Sans Frontieres (Msf) - Nairobi Area

Published a month ago

Nutrition Graduate Intern At Nestle

Nutrition Graduate Interns Candidates need the following: Marketing – Bcom in Marketing/Sales Must attain a minimum of 65% as an Academic result Good reporti...


From Nestle - Nairobi Area

Published a month ago

Built at: 2024-11-07T19:51:16.698Z