Partnership Claims Adjustment Senior Advisor

hace 1 semana


Madrid, España Cigna A tiempo completo

.About us Cigna is one of the world's leading providers of health care, expatriate employee benefits, life, accidental and supplemental health insurance. Headquartered in the US and listed in NYSE, the Company operates in countries across the Americas, Europe, Africa and Asia Pacific.Cigna Europe and Global Segments is an integral part of Cigna's growing international businesses. Product types include: Medical, Dental, Vision, Life, AD&D, Disability, Travel, etc. are sold to groups and individuals. More than 3000 employees are operating for Cigna Europe and Global Segments.Your job We have an exciting opportunity to join Cigna as a Claims Adjuster where you will be part of our Global Service Centre supporting clients from across the world. Reporting to the Claims Senior Supervisor, you will be responsible for the efficient and timely processing of adjustments and failed payments related to Dental/Vision and Medical claims as received from providers/partners, clients and members.Cigna Global Health Benefits, a division of Cigna Corporate, is a leading provider of group healthcare programmes for expatriate employees of large multinational organizations and their families. With over 25 years' experience in this field, we have established businesses in the USA, UK, Spain, Germany, Switzerland, France, Sweden, Benelux and the Middle East.Main Duties/Responsibilities:Adjudicate international medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.Monitor the quality of the team's high-cost claims according to the payment authority architecture.Monitor the financial deviations across the different systems and perform the required adjustments.Review and improve the standard operating procedures, identify potential gaps, and make recommendations to the Claims Supervisor.Monitor and highlight high-cost claims and ensure relevant parties are aware.Monitor turn-around times to ensure your claims are settled within required time scales, highlighting to team senior when this is not achievable.Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status, and perform necessary action as required, with first call resolution where possible.Interface effectively with internal and external customers to resolve customer issues.Actively support other team members and provide resources to enable all team goals to be achieved.Carry out other ad-hoc tasks as required meeting business needs.Skills/Qualities:We want people to draw on their life experience, personality and individual talents. Broadly speaking, we look for:Ideally, contact centre or office environment experience.Ability to meet/exceed targets and manage multiple priorities.Number driven and decision maker.Experience in continuous improvement and process mapping would be valuable.Proficient in Microsoft Office applications.Preferred if English and Arithmetic qualification gained



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