Claims Representative

Cigna Healthcare; Bengaluru; On-site; INR 550,000 - 750,000; Full time

Job summary

CIGNA Healthcare, Bengaluru, is seeking a Claims Processing Associate to handle basic technical, administrative, or operative claims tasks. You will adjudicate international claims, process paper and electronic claims, and perform data entry under supervision.

The role serves as an entry point into professional careers in healthcare administration and claims processing. The position requires a graduate background and 2–4 years of experience in global healthcare claims processing.

Qualifications

• Good English language communication skills, both verbal and written.
• Computer literate and proficient in MS Office.
• Excellent critical thinking and decision-making skills.
• Ability to meet/exceed targets and manage multiple priorities.
• Must possess excellent attention to detail, with a high level of accuracy.
• Strong interpersonal skills.
• 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.
• Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential.

Responsibilities

• Adjudicate international claims in accordance with policy terms and conditions.
• Monitor SLA times to ensure your claims are settled within required time scales.
• Respond to all claim enquiries within set SLA performing the necessary action as required, striving for first contact resolution where possible.
• Communicate effectively with internal and external stakeholders to deliver excellent customer outcomes.
• 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.
• Carry out other adhoc tasks as required in meeting business needs.
• Work cohesively in a team environment.
• Adhere to policies and practices, training, and certification requirements.

Skills

English communication

MS Office proficiency

Attention to detail

Customer focus

Team collaboration

Education

Graduate (Any) - medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science

Tools

MS Office

Job description

About Us

At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day.

One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We are devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being.

CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization.

Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us!

Process Overview*

• EU insurance claims processing for individual, employer, group, and provider.

Job Description*

• Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. 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.

Responsibilities: -

• Adjudicate international claims in accordance with policy terms and conditions. M
• Monitor SLA times to ensure your claims are settled within required time scales.
• Respond to all claim enquiries within set SLA performing the necessary action as required, striving for first contact resolution where possible.
• Communicate effectively with internal and external stakeholders to deliver excellent customer outcomes.
• 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.
• Carry out other adhoc tasks as required in meeting business needs.
• Work cohesively in a team environment.
• Adhere to policies and practices, training, and certification requirements.

Requirements*:

• Working knowledge of the insurance industry and relevant federal and state regulations.
• Good English language communication skills, both verbal and written.
• Computer literate and proficient in MS Office.
• Excellent critical thinking and decision-making skills.
• Ability to meet/exceed targets and manage multiple priorities.
• Must possess excellent attention to detail, with a high level of accuracy.
• Strong interpersonal skills.
• 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.
• Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential.

Education* : Graduate (Any) - medical, Paramedical, Commerce, Statistics, Mathematics, Economics or Science.

Experience Range* : Minimum 2 years and up to 4 years of experience in processing of global healthcare insurance claims.

Foundational Skills* -

• Expertise in EU insurance claims processing

Work Timings* : 1:00-10:00 PM IST

Job Location*: Bengaluru (Bangalore)

About The Cigna Group

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.