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Resolution Team Claims Adjustor

3 months ago

Greenock, Inverclyde, United Kingdom The Cigna Group Full time
The job profile for this position is Claims Representative, which is a Band 1 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.

Job Description – Partnership Claims Adjustment Advisor

We have an exciting opportunity to join Cigna as a Claims Adjuster where you will be part of our Global Service Centre supporting clients from across the world. Reporting to the Claims Supervisor, you will be responsible for the efficient and timely processing of adjustments and failed payments related to Dental/Vision and Medical claims as received from providers/partners, clients and members.

Cigna Global Health Benefits, a division of Cigna Corporate, is a leading provider of group healthcare programmes for expatriate employees of large multinational organisations and their families. With over 25 years' experience in this field, we have established businesses in the USA, UK, Spain, Germany, Switzerland, France, Sweden, Benelux and the Middle East.

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 team senior 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 ad-hoc tasks as required meeting business needs.

Skills/Qualities:

We want people to draw on their life experience, personality and individual talents. Broadly speaking, we look for:

  • Ideally, contact entre or office environment experience
  • Ability to meet/exceed targets and manage multiple priorities.
  • Proficient in Microsoft Office applications.
  • Preferred if English and Arithmetic qualification gained.
  • 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 judgment.

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