Claims Associate Representative

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 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 your Supervisor 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. 

• Identify potential process improvements and make recommendations to team senior. 

• Actively support other team members and provide resource to enable all team goals to be achieved. 

• Work across European business in line with service needs. 

• Carry out other adhoc tasks as required meeting business needs.

Experience Required: 

• Customer focused with ability to identify and solve problems.

• Ability to meet/exceed targets and manage multiple priorities. 

• Proficient in Microsoft Office applications. 

• Preferred if English and Arithmetic qualification gained. 

• Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. 

Skills: 

• Must possess excellent attention to detail, with a high level of accuracy. 

• Strong interpersonal skills with good verbal and written communication to internal and external clients. 

• Strong customer focus with ability to identify and solve problems. 

• Ability to work under own initiative and proactive in recommending and implementing process improvements. 

• Ability to organise, prioritise and manage workflow to meet individual and team requirements 

• Ability to exercise judgment.

About The Cigna Group