Access to Care Specialist - Cigna Healthcare

Cigna Healthcare; Kuala Lumpur; Hybrid; MYR 55,000 - 90,000; Full time

Benefits offered by this job

International health insurance经验

Knowledge of pre-authorisation and GOP

Healthcare, insurance, or medicalAdmin

Experience with global providers

Job summary

Cigna Healthcare is seeking an Access to Care Specialist to help customers access needed healthcare services. You will manage care journeys, pre-authorisation, and GOP requests while collaborating with providers and internal teams.

The role requires strong case management, policy interpretation, and excellent communication. You will operate in a fast-paced environment, balancing cost, quality, and timely outcomes to ensure a positive customer experience.

Qualifications

• Experience in case management and coordinating care across providers.
• Ability to interpret policy benefits, coverage and exclusions.
• Experience handling pre-authorisation processes and GOP documentation.
• Strong documentation and record-keeping skills.
• Ability to manage multiple priorities and balance customer needs with cost considerations.

Responsibilities

• Owns healthcare cases from initial contact to resolution with timely guidance.
• Explain benefits and coverage clearly and provide regular progress updates.
• Coordinate treatment plans with providers and obtain medical information and cost estimates.
• Process pre-authorisation and GOP documentation within service standards.
• Promote use of in-network providers and support cost containment.
• Build relationships with customers, providers and internal teams for seamless care.
• Maintain regulatory compliance and contribute to process improvements.

Skills

Case management

Care coordination

GOP administration

Policy interpretation

Documentation

Education

Healthcare, insurance, or medical administration qualification

Job description

About Cigna Healthcare

Cigna Healthcare is a global health service company dedicated to transforming healthcare. With roots in the U.S. and operations in over 30 countries, we serve more than 180 million customers and patients worldwide. Ranked 13th on the Fortune 500 in 2025, Cigna is recognized as one of the most trusted and influential names in the industry.

Our mission is to improve the health, well-being, and peace of mind of those we serve.

You'll join a globally recognized organization where trust, clear communication, and a positive culture shape how we work. Our leaders are consistent, approachable, and supportive, helping you maintain balance while doing meaningful work.

We look for people who thrive in collaborative environments, care about meaningful change, and want to grow in a company that puts people first. At Cigna Healthcare, your work contributes to better care experiences and supports customers through important moments in their lives.

About the Role

As an Access to Care Specialist, you will play a key role in helping customers access the healthcare services they need. You will coordinate care journeys, manage pre-authorisation and Guarantee of Payment requests, and work closely with customers, healthcare providers, medical teams, and internal partners to deliver timely, high-quality outcomes.

You will operate in a fast-paced and evolving environment where priorities can change quickly. Success in this role comes from taking ownership of complex cases, maintaining clear communication, and seeing work through to resolution while balancing customer needs, quality standards, and cost-effective care.

What You'll Do

• Take ownership of healthcare cases from initial contact through to resolution, ensuring customers receive timely support and guidance throughout their treatment journey.
• Deliver a positive customer experience by clearly explaining benefits, coverage, exclusions, and next steps, while providing regular updates on case progress.
• Coordinate treatment arrangements and collaborate with healthcare providers to obtain medical information, treatment plans, and cost estimates.
• Review and process pre-authorisation requests and Guarantee of Payment documentation within agreed service standards.
• Promote appropriate use of in-network providers and support cost-containment initiatives while maintaining excellent customer outcomes.
• Build effective relationships with customers, healthcare providers, Medical Advisors, Clinical teams, and internal stakeholders to ensure seamless care coordination.
• Maintain accurate documentation, comply with regulatory and policy requirements, and contribute to continuous improvement initiatives that enhance service quality and efficiency.

What You'll Bring

• Experience in customer service within healthcare, insurance, medical assistance, or a related environment.
• Experience managing customer cases from initiation through to resolution.
• Ability to interpret policy information, benefits, and coverage details accurately.
• Experience working to service levels, quality standards, and customer-focused performance measures.
• Ability to manage multiple priorities and make sound decisions when handling complex cases.
• A commitment to delivering high-quality customer service while maintaining attention to detail and accuracy.

Soft Skills

• Customer service and relationship-building skills
• Strong verbal and written communication
• Problem-solving and decision-making ability
• Organisation and time-management skills
• Empathy and emotional intelligence
• Ability to work independently and collaboratively
• Adaptability in a changing operational environment

Technical / Functional Skills

• Case management and care coordination
• Pre-authorisation processing
• Guarantee of Payment (GOP) administration
• Healthcare benefit and policy interpretation
• Documentation and record management
• Stakeholder and provider management
• Regulatory and compliance awareness

Nice to Have

• International health insurance experience
• Knowledge of pre-authorisation and GOP processes
• Healthcare, insurance, or medical administration qualification
• Experience working with global healthcare providers

Why Join Us

• Competitive salary and benefits package.
• Multicultural and hybrid working environment with opportunities to collaborate across international teams.
• Private Medical Insurance and Employee Wellbeing Benefits to support your health and wellbeing.
• Educational Development Program to help you continue learning and growing your career.
• The opportunity to make a meaningful impact by helping customers access the right care at the right time.

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.