Reconciliation Agent - Cigna Healthcare

Cigna Healthcare; Kuala Lumpur; Remote; MYR 52,000 - 78,000; Full time

Job summary

Cigna Healthcare in Malaysia is seeking a Provider Reconciliation Agent to join the Global Provider Reconciliation team within Provider Services. You will review reconciliation requests for paid medical claims, investigate bill status using Cigna payment systems, and coordinate with other departments to resolve cases within established timeframes.

You will monitor communications with globally distributed medical facilities and serve as a point of contact for provider inquiries, while supporting

Qualifications

• At least 1 year of experience in a customer service role.
• Good English language skills; additional language is a plus.
• International mindset with ability to work remotely with global colleagues and providers.
• Desire to deliver excellent service to members, clients and providers.
• Detail oriented with high accuracy and strong time management.
• Ability to engage in multiple tasks and meet deadlines/standards.
• Act with urgency to research questions and identify the right resources.

Responsibilities

• Review reconciliation requests from providers using relevant systems.
• Investigate status of bills and coordinate with other teams to resolve cases within timeframes.
• Follow up on cases needing additional support to help facilities interpret feedback.
• Manage inbound/outbound communications with providers globally and internal requests.
• Handle intake process of reconciliation cases including upload and priority setting.
• Support GPR teammates to achieve group goals and suggest process improvements.
• Provide feedback on urgent or critical cases needing action.
• Deliver on operational KPIs within the GPR team (production, quality, TAT).

Skills

Customer service

English

Time management

Attention to detail

Problem solving

Communication

Independent work

Growth mindset

Tools

SharePoint

Microsoft Office

Job description

YOUR JOB As a Provider Reconciliation Agent you will be part of a Global Provider Reconciliation (GPR) Team embedded into the Provider Services department. Your main responsibilities will be related with review of the reconciliation requests from providers on the paid medical claims where you would need to investigate the status of a certain bill using Cigna relevant payment systems. For some specific cases you would be in contact with different departments within Cigna to take necessary steps in order to resolve the reconciliation cases according to the established timeframe. Apart from this you will be monitoring the incoming/outgoing communications with our globally distributed medical facilities as well as be a point of contact for other departments with any provider claims related queries.

YOUR JOB As a Provider Reconciliation Agent you will be part of a Global Provider Reconciliation (GPR) Team embedded into the Provider Services department. Your main responsibilities will be related with review of the reconciliation requests from providers on the paid medical claims where you would need to investigate the status of a certain bill using Cigna relevant payment systems. For some specific cases you would be in contact with different departments within Cigna to take necessary steps in order to resolve the reconciliation cases according to the established timeframe. Apart from this you will be monitoring the incoming/outgoing communications with our globally distributed medical facilities as well as be a point of contact for other departments with any provider claims related queries.

Your role includes

• You will be responsible for the initial review of the reconciliation requests received from providers using relevant supporting systems;
• Performing deeper investigation on certain cases together with further coordination with other teams in order to solve the cases according to the established standards;
• As part of the reconciliation review, you will be following up on the cases where additional support is needed to help the facility interprete our feedback and take necessary steps;
• Managing the incoming and outgoing communications with our providers globally and handling the internal requests related to provider inquiries;
• Performing the intake process of the reconciliation cases which will include upload, priority setting and close follow up on the completion;
• Actively support other GPR team members and provide help to enable team goals to be achieved;
• Being able to identify any process improvement and make recommendations for potential changes;
• Provide feedback to the GPR team on urgent or critical cases that need special action or attention;
• Deliver on operational KPI’s within the GPR team in terms of production, quality, TAT, amongst others;

YOUR PROFILE

• At least 1 years of experience in a customer service role;
• Good English language skills, additional language is a plus;
• International mind-set able to work remotely with colleagues, partners and providers across the globe;
• Striving for excellent service to our members, clients and providers is part of your DNA;
• Detail oriented with high accuracy level and proven time management and organization skills (including the ability to engage in multiple tasks and meet deadlines/standards);
• Act with a sense of urgency to research questions or issues brought by different teams. Identify the right parties or resources to resolve these issues;
• Strong customer focus with ability to identify and solve problems;
• Strong interpersonal skills with good verbal and written communication to internal and external parties;
• Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.
• A growth mindset with a positive attitude towards change and the ability to play an active role in implementing change initiatives.
• Accountability – to assume ownership for achieving personal results and to contribute for collective team goals;
• Working knowledge of SharePoint & Microsoft office;

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.