Claims Senior Representative

hace 3 días


Madrid, Madrid, España The Cigna Group A tiempo completo
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 Claims Organization, you will be responsible for delivering specific delegated claims tasks assigned by a supervisor. Your primary focus will be on examining and processing paper claims and/or electronic claims, determining whether to return, pend, deny or pay claims within policies, and following established departmental policies and procedures to resolve claims and claims issues.

Main Responsibilities:
• Examines and processes paper claims and/or electronic claims.
• Determines whether to return, pend, deny or pay claims within policies.
• Follows established departmental policies and procedures to resolve claims and claims issues.
• Settles claims with claimants in accordance with policy provisions.
• Interacts with agents and claimants by mail or phone to correct claim form errors or omissions and to investigate questionable entries.
• Completes day-to-day tasks without immediate supervision, but has ready access to advice from more experienced team members.

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.

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