Reconciliation Agent - Cigna Healthcare

CIGNA Worldwide General Insurance Company Limited; Kuala Lumpur; Remote; MYR 56,000 - 100,000; Full time

Job summary

Cigna Worldwide General Insurance Company Limited is seeking a Provider Reconciliation Agent to join the Global Provider Reconciliation (GPR) Team within Provider Services. You will review reconciliation requests from providers on paid medical claims and investigate bill status using Cigna payment systems.

You will coordinate with multiple departments, monitor communications with globally distributed facilities, and ensure timely resolution of cases while contributing to KPIs and process

Qualifications

• Minimum 1 year of experience in customer service.
• Good English language skills; additional languages a plus.
• Able to work remotely with colleagues across the globe.
• Strong time management and high attention to detail.

Responsibilities

• Review reconciliation requests from providers using relevant systems.
• Investigate cases and coordinate with other teams to resolve them.
• Follow up to help facilities interpret feedback and take action.
• Manage communications with providers globally.
• Perform intake and prioritization of reconciliation cases.
• Support team members to achieve goals.
• Identify process improvements and suggest changes.
• Provide feedback on urgent or critical cases.
• Help meet KPIs for production, quality, and turnaround time.

Skills

Customer service

English proficiency

Remote collaboration

Time management

Communication

Detail oriented

Tools

SharePoint

Microsoft Office

Job description

CIGNA Worldwide General Insurance Company Limited View all jobs

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

• Atleast 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.

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

• Atleast 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.

Unlock job insights

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Whatever your health insurance needs, our International Medical Plans can be tailored to meet them, while always offering a global support network of hospitals and medical professionals.

Whole health is a new way to think about care that allows Cigna to look at the full picture. To widen its scope, to acknowledge the full spectrum of factors that make up who you are and how you feel at any given time. So that, ultimately, we can help people live their lives in full – the good, the bad and every moment in between, knowing that you are supported in every aspect of your world.

Whatever your health insurance needs, our International Medical Plans can be tailored to meet them, while always offering a global support network of hospitals and medical professionals.

Whole health is a new way to think about care that allows Cigna to look at the full picture. To widen its scope, to acknowledge the full spectrum of factors that make up who you are and how you feel at any given time. So that, ultimately, we can help people live their lives in full – the good, the bad and every moment in between, knowing that you are supported in every aspect of your world.