Medical Claims Analyst Jobs, Service Related Jobs, Career Opportunities,
Senior CSR–COCE & COM (Evening shift)
As a Senior CSR you will support the supervisor and team manager in your relevant process .The role will be hybrid between calls and emails and you are required to support on both contact channels based on the operational needs.
Your role includes:
Knowledge reference and Escalation contact point
- Working on Emails/Calls based on the workplan assigned by the Sv’s.
- Assists the team with difficult Calls/Emails (escalations) and ( complaint cases) Calls/Emails
- Being a point of contact and actively support the team by addressing their questions and guide them on the ways to work on cases for any contracts
- Prepare case summary and propose correct process for any escalated cases
- Being a good reference and great example for the new hires/Junior team members for both call and email process.
- Act as the Single of Point for a dedicated contracts ,at the same time able to handle and guide the team for all the contracts.
- Support Trainer /SME with new hires training / refresher trainings
- Active participation in training verification queues, shadowing sessions for calls and mentorships
- Proactively communicate improvement areas for the new /junior CSR to Supervisors while working on verification queue.
- Ownership and expectation
- As Senior CSRs you lead by example in both quality and productivity.
- Taking ownership of any escalated cases and providing updates to the Supervisors or Senior Supervisors on any issues
- Respond within the time commitment given to enquiries and escalations, with first contact resolution.
- Manage customer interactions mainly calls and emails through the development of high quality interpersonal skills and customer centricity
- Taking ownership of solving any customer issues by working closely with other internal/external departments.
- Identify potential process improvements and make recommendations.
- Proactively address and/or escalate any risks
- Go above and beyond to deliver great customer experience and lead by an example
- Strong performance track record
- Able to work on dedicated evening shift from 3pm till 1am local time including weekends based on shift rotation
- International mindset, with holistic and able to work remotely with peers across locations
- 2 years of Cigna experience
- Good communication skills, and knowledge of Window tools, e.g. Excel, PowerPoint,
- A growth mindset with a positive attitude towards change and the ability to play an active role in implementing change initiatives within your own process
- Actionorientated problemsolving attitude
- Able to seek out best practice in order to effectively deal with diverse, complex and highly sensitive issues
- Accountability – assume ownership for achieving personal results and collective team goals
Medical Claims Review Associate Analyst
You will be:
- Interpreting key information from medical reports/invoices and translating this into medical coding in our hospitalization database and/or Salesforce application ‘Healthcloud’
- Analyzing invoices from providers all over the world to identify cost containment opportunities and you will be taking appropriate actions in line with our procedures to avoid unnecessary costs for our clients ,members and Cigna
- Collaborating with colleagues in different teams and roles (Claims Analysts, CSR’s, Doctors, Nurses etc.) across the business while bridging cultural differences & backgrounds
- Connecting with providers to obtain (additional) medical information
- Attending weekly/Monthly/ad-hoc meetings with the team & supervisor to discuss and improve internal workflows and collaboration
- Serving as a contact person for other teams within Clinical and the wider business for expert advice on R&C calculations
- Taking ownership of your production making sure you meet the expected outputs
- Proficient in English
- Active or passive knowledge of French/German/Italian. Additional languages are a plus
- Experience with processing provider claims
- Clinical background is a plus
- Communicative and not afraid to approach people
- Proactive and driven
- You can deal with integrity
- Tech savvy, not afraid to work in/with different systems/applications at the same time
- Eye for detail and love for accurateness
- Flexible with the ability to shift priorities when required
- Not afraid of moving forward in the midst of ambiguity
- A permanent job in an international and growing enterprise
- A nice team of enthusiastic and diverse CARE team members in different work locations
- A dynamic, young and entrepreneurial company culture that values and stimulates initiative
- Flexible working hours with the opportunity to work from home