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 Europe and Global Segments is an integral part of Cigna's growing international businesses. Product types include: Medical, Dental, Vision, Life, AD&D, Disability, Travel, etc. are sold to groups and individuals. More than 3000 employees are operating for Cigna Europe and Global Segments.
Your job
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 Senior 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.
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 the quality of the team's high-cost claims according to the payment authority architecture.
Monitor the financial deviations across the different systems and performing the required adjustments.
Review and improvement of the standard operating procedures, identification of potential gaps making recommendations to the Claims Supervisor. Process mapping.
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.
Actively support other team members and provide resource to enable all team goals to be achieved.
Carry out other ad-hoc tasks as required meeting business needs.
Skills/Qualities:
Ideally, contact center or office environment experience.
Ability to meet/exceed targets and manage multiple priorities.
Number driven and decision maker.
Experience in continuous improvement and process mapping would be valuable.
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 organize, prioritize and manage workflow to meet individual and team requirements.
Ability to exercise judgment.
What we offer?
Type of Contract: Permanent.
Multicultural working environment: A diverse job in an international context with impressive clients.
Hybrid working: Enjoy working from the comfort of your home 3 days per week and 2 days from our Madrid office. Cigna's "Happy You": health and wellbeing initiatives, flexible work hours, home working opportunities.
Flexible starting hour: Official Schedule Monday to Friday 9.00 to 17.00 but with flexibility. Our shifts are from 7:00 to 9:30, with the possibility to choose the time that suits you best.
A wide range of social benefits and attractive salary packages.
About Cigna Healthcare
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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