Claims Resolution Specialist
hace 2 días
About Cigna Healthcare Solutions
">We are a leading provider of group healthcare programs for expatriate employees of large multinational organizations and their families. With over 25 years' experience in this field, we have established businesses in the US, UK, Spain, Germany, Switzerland, France, Sweden, Benelux, and the Middle East.
Main 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 financial deviations across different systems and perform required adjustments.
- Review and improve standard operating procedures, identify potential gaps, and make recommendations to the Claims Supervisor.
- Monitor turn-around times to ensure claims are settled within required time scales, highlighting to team senior when this is not achievable.
Our ideal candidate will possess the following skills and qualifications:
- Contact centre or office environment experience.
- Able to meet/exceed targets and manage multiple priorities.
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