Medical Claims & Pre-Approvals Specialist

Cigna Health and Life Insurance Company; Kuala Lumpur; On-site; MYR 36,000 - 60,000; Full time

Job summary

Cigna Health and Life Insurance Company in Kuala Lumpur is seeking a claims processing professional to support provider inquiries and medical coverage determinations. You will process claims, verify eligibility, and maintain pre-authorizations in line with policy terms.

The role requires 1–2 years of relevant experience, strong organizational skills, and proficiency in Microsoft Office. Shift-based work is possible to meet service demands.

Qualifications

• Experience handling medical claims and provider inquiries.
• Strong data entry and organizational skills.
• Ability to meet processing targets and SLA.

Responsibilities

• Process claims from providers in line with policy coverage and medical necessity.
• Assess eligibility and medical necessity within policy boundaries.
• Maintain pre-authorizations and claims processing per terms and policies.
• Monitor SLA, quality, and KPI targets for claims and pre-approvals.
• Collaborate with cross-functional teams to resolve queries and support operational goals.

Skills

Claims processing

Data entry

Customer service

Microsoft Office

Tools

Microsoft Office

CRM systems

Job description

Cigna Health and Life Insurance Company in Kuala Lumpur is seeking a claims processing professional to support provider inquiries and medical coverage determinations. You will process claims, verify eligibility, and maintain pre-authorizations in line with policy terms.

The role requires 1–2 years of relevant experience, strong organizational skills, and proficiency in Microsoft Office. Shift-based work is possible to meet service demands.