APAC Medical Claims Specialist

Cigna Health and Life Insurance Company; Kuala Lumpur; Sur place; MYR 50 000 - 78 000; Plein temps

Résumé du poste

Cigna Health and Life Insurance Company in Kuala Lumpur is seeking a Claims Specialist to support providers and payers by processing claims, answering inquiries, and maintaining pre-authorizations and related records. The role emphasizes accuracy, confidentiality, and adherence to policy terms while delivering timely service.

You will work with cross-functional teams, manage workload within SLAs, and adapt to shifts, including weekends for overtime.

Qualifications

• 1-2 years of similar role experience.
• Experience in an international company preferred.
• Broad awareness of medical terminology.
• Excellent organizational skills and adherence to procedures.
• First-class written and verbal communication skills.
• Ability to communicate across a diverse population.
• Capable of independent work; good time management.
• Willingness to work shifts and weekends for overtime.

Responsabilités

• Process claims from members and providers.
• Assist queries from providers and payers via phone or email.
• Maintain files for authorizations and other reports.
• Assess and process claims in line with policy coverage and medical necessity.
• Be versed with medical insurance policies for various groups/beneficiaries.
• Collaborate with cross-functional teams to resolve queries.
• Meet or exceed SLAs, KPIs, and quality targets.
• Monitor high-cost claims and reconciliation work.

Connaissances

Communication skills

Time management

Microsoft Office

Independent worker

Diversity communication

Adaptability

Outils

Microsoft Office

Description du poste

Cigna Health and Life Insurance Company in Kuala Lumpur is seeking a Claims Specialist to support providers and payers by processing claims, answering inquiries, and maintaining pre-authorizations and related records. The role emphasizes accuracy, confidentiality, and adherence to policy terms while delivering timely service.

You will work with cross-functional teams, manage workload within SLAs, and adapt to shifts, including weekends for overtime.