Hybrid Medical Claims Specialist

Cigna Health and Life Insurance Company; Kuala Lumpur; Ibrido; MYR 42.000 - 66.000; Tempo pieno

Descrizione del lavoro

The Cigna Group, via Cigna Healthcare, is hiring a Claims Representative PSO for the Kuala Lumpur, Malaysia, hybrid role. The position involves processing medical claims, assessing eligibility, and ensuring accuracy and timeliness in line with benefit policies.

The role requires 1–2 years of related experience, strong MS Office skills, and the ability to work in a fast-paced, customer-focused environment. Weekend shifts and overtime may be required.

Competenze

• 1-2 years of experience in a similar role.
• Experience in an international company is preferred.
• Claims processing or insurance experience is preferred.
• Broad awareness of medical terminology is advantageous.
• Strong organizational skills and ability to follow procedures.
• Excellent written and verbal communication skills.

Mansioni

• Processes claims from providers.
• Assesses and processes claims in line with policy coverage and medical necessity.
• Maintains knowledge of medical insurance policies for various groups or beneficiaries.
• Accurately assesses eligibility within policy boundaries.
• Monitors claims processing and achieves required targets.
• Complies with terms, system updates, and SOPs.
• Handles recoupment and reconciliation work and communicates with providers and members.
• Works with cross-functional teams to resolve queries and support operational goals.

Conoscenze

Claims processing

Insurance knowledge

MS Office

Communication skills

Time management

Independent work

Strumenti

MS Office

Descrizione del lavoro

The Cigna Group, via Cigna Healthcare, is hiring a Claims Representative PSO for the Kuala Lumpur, Malaysia, hybrid role. The position involves processing medical claims, assessing eligibility, and ensuring accuracy and timeliness in line with benefit policies.

The role requires 1–2 years of related experience, strong MS Office skills, and the ability to work in a fast-paced, customer-focused environment. Weekend shifts and overtime may be required.