Claims Senior Representative
hace 2 días
Job Summary: We are seeking a highly motivated and experienced Claims Senior Representative to join our team in Madrid. As a key member of our Operations Team, you will be responsible for delivering specific delegated Claims tasks assigned by a supervisor, examining and processing paper claims and/or electronic claims, and determining the necessary steps for adjudication.
Main Responsibilities:
- Provide coaching and development for Claims team staff
- Review team performance and ensure coaching opportunities are identified
- Ownership of BPO team scorecards, updating performance and ensuring coaching opportunities are identified
- Quality Audit execution and reporting results, ensuring Quality Audit targets are achieved
- Engage staff to create a dynamic working environment at all levels, supporting the team and the processes towards continuous improvement
- Proactively optimize the unit's workflows to achieve set targets
- Managing the senior queues daily
- Monitoring and managing workflow to ensure TAT targets are achieved and inventory levels are managed
- Instrumental in the Claims Processes to ensure risks are highlighted
- 1st Point of contact for Escalations
- Mainframe and financial transactions
- Ad-hoc projects
- As Required, processing or verifying
Requirements:
- 1 year experience in processing Provider claims
- Ability to complete tasks with little or no supervision
- Self-motivated with a proactive approach
- Exceptional attention to detail and accuracy
- Ability to take ownership
- Demonstrated Coaching/Development Experience
- Work well in a team environment
- Computer literacy (especially Excel)
- Ability to learn in a virtual environment
- Excellent problem-solving skills
- Confidentiality Management of Data
- Leadership Skills will be a plus
About Cigna Healthcare: Cigna Healthcare is an advocate for better health through every stage of life. We guide our customers through the healthcare system, empowering them with the information and insight they need to make the best choices for improving their health and vitality.
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