Claims Senior Representative - Cigna Healthcare

Cigna Healthcare; Kuala Lumpur; Vor Ort; MYR 50.000 - 80.000; Vollzeit

Zusammenfassung

Cigna Healthcare Malaysia is seeking a Claims Analyst to handle medical expense claims with confidentiality. You will assess, process, and input data accurately, aiming for timely reimbursements and high data integrity.

The role requires familiarity with English and Mandarin, meticulous attention to detail, and strong teamwork to improve workflows. A bachelor’s degree or equivalent and office/CRM experience are preferred.

Qualifikationen

• Bachelor degree or equivalent required.
• Proficiency in medical terminology.
• Strong data entry and confidentiality.
• Good command of English and Mandarin.
• Familiar with policy coverage.

Aufgaben

• Process medical expense claims within fixed turnaround time.
• Input data accurately into system applications.
• Maintain confidentiality and data integrity of files.
• Monitor workload, timelines, and follow up on open files.
• Collaborate with Claims Supervisor to optimize processes.
• Provide training to trainees and support colleagues.
• Communicate clearly with internal staff about dossiers.
• Assist in contract updates and refresher trainings.

Kenntnisse

Decision making

Numerical skills

Data accuracy

Attention to detail

Discipline

Efficiency

Teamwork

Discretion

Office applications

Ausbildung

Bachelor degree or equivalent

Language knowledge (English/Mandarin)

Medical terminology

Policies coverage

Use of reference works

Tools

Microsoft Office

CRM

Tailor-made software

Cigna systems

Jobbeschreibung

Job Description

Scope

Critical analysis and processing of claims for medical expenses within the fixed turn around time.

Job content

Claims processing

• Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality.
• Accurate data input to the system applications.
• Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods.
• Following up his/her own workload (volume and timing): keeping an eye on chronology and processing time of the work volume and taking suitable actions.
• Participate efficiently in processing the flow of claims: inform the Claims Supervisor about claims lacking clarity and about possible ways of optimizing the processes.
• A sustained effort towards high-quality claims handling, accurate reimbursements and fast transactions are important motivators.

In relation to other positions

• Act as focal point of contact for cases, questions from other Claims Analysts and following-up on files
• Providing accurate communication about a dossier to the interested internal employee.
• Tracking irregularities in procedures and highlighting these to the Claims Supervisor.
• Raising problems or sensitivities with your superior.
• Coaching and training trainees
• Participating actively in an agreeable and amicable atmosphere.

Additional task

• Financial verification
• Assisting Claims Supervisor, Claims in work planning, implementation of new contract, updating of Contract Summary, conducting refresher trainings
• Work closely with SMEs & Claims Supervisor and identify areas for improvement based on customer feedback on our services.

PROFILE Education Level

• Bachelor degree or similar by experience
  Specific Knowledge
• Passive language knowledge (English, Mandarin etc.)
• Policies coverage
• Medical terminology
• Use of necessary reference works

Skills

• Skillful in taking decisions: takes the right action on allocated files based on the available information.
• Skillful with numbers: likes to work with numbers.
• Accurate: works accurately on the input of data, aims to work faultlessly.
• Discipline: pays attention to procedures, agreements and document flows.
• Efficient: finds a good balance between quality and quantity.
• Team player: Able to work in a team.
• Skillful with computer programs: readily learns the ropes in the use of current office applications and own Cigna International systems.
• Discreet: works discreetly with confidential (medical) information.
• Active knowledge of Tools needed to perform main tasks and responsibilities, such as Microsoft Office applications, CRM and tailor made software.

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.