APAC Complaints Investigator & Resolution Specialist

Cigna Healthcare; Kuala Lumpur; On-site; MYR 60,000 - 90,000; Full time

Job summary

Cigna Healthcare in Kuala Lumpur is seeking an APAC Complaints Analyst to own and resolve complaints end-to-end, ensuring fair, evidence-based outcomes and auditable records. You will collaborate across claims, clinical, customer service, client management, compliance and other teams to investigate, document root causes, and escalate where required, delivering timely, empathetic final responses.

The role emphasizes adherence to service timelines, data privacy and regulatory standards, with a

Qualifications

• Experience in complaint handling or a regulated environment such as insurance or healthcare.
• Strong investigation and analytical problem-solving abilities.
• Excellent written and verbal English with clear, empathetic communication.

Responsibilities

• Manage an allocated caseload end to end, prioritising by deadline, complexity and customer risk.
• Recognise and accurately record formal complaints, distinguishing them from service queries and escalations.
• Gather and assess relevant evidence including calls, correspondence, system notes, policy terms and stakeholder input.
• Build a clear chronology, identify root causes and test whether processes and communications were correct and reasonable.
• Interpret policy terms and guidance accurately, seeking specialist input where required.
• Reach balanced, defensible outcomes and recommend proportionate redress within authority.
• Produce clear acknowledgements, progress updates and final responses with evidence, decision, rationale and escalation rights.
• Maintain complete records in Salesforce and trackers with actions, evidence and remediation.
• Identify vulnerability and compliance concerns and escalate when needed.
• Collaborate with claims, clinical, customer service and other partners to remove blockers and secure timely resolution.
• Escalate complex or high-value cases with concise summaries and recommended steps.
• Contribute to quality reviews and knowledge sharing to drive improvement.
• Analyse complaint themes and recurring issues to capture corrective actions.

Skills

Complaint handling

Investigation skills

Analytical thinking

English communication

Education

Tools

Salesforce

Job description

Cigna Healthcare in Kuala Lumpur is seeking an APAC Complaints Analyst to own and resolve complaints end-to-end, ensuring fair, evidence-based outcomes and auditable records. You will collaborate across claims, clinical, customer service, client management, compliance and other teams to investigate, document root causes, and escalate where required, delivering timely, empathetic final responses.

The role emphasizes adherence to service timelines, data privacy and regulatory standards, with a