Care Access Navigator | Healthcare Support

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

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.