Claims Team Leader - non-BAU

Cigna is one of the largest International Medical Insurers worldwide and can trace its roots back over 200 years. We are looking for a highly motivated, focused individual to join our team. You will have the opportunity to work for a forward thinking and progressive organisation, within a dynamic team environment where there are tangible progression opportunities.
Cigna International’s Global Individual Health business is a leader in providing international health insurance to expatriates and other globally mobile individuals.
Claims Team Leader (non-BAU) Role Description

As a Claims Team Leader, you will lead a team focused on managing complex, non-standard claims processes. This role requires specialised oversight of key areas, including Failed Payments, Waiting Approvals, SIU (Special Investigations Unit), Escalations, Priority Broker experience, and queue triaging. You will drive efficient claims processing, ensure compliance, and enhance customer satisfaction by implementing effective procedures and fair customer outcomes.

Responsibilities
Your role will involve:

• Managing and overseeing non-BAU claims activities, including:
  • Failed payments and claims requiring approvals.
  • Priority claims from brokers and other high-urgency tasks.
  • SIU coordination to investigate and address escalated claims.
  • Queue triaging to ensure timely handling of all incoming claims.
• Reviewing and analysing insurance claims to verify validity and assess settlements across both BAU and high-value cases.
• Implementing and optimising procedures to increase the efficiency of claims processing, particularly for failed payments and pending approvals.
• Coordinating effectively with your team, brokers, and customers to obtain necessary information for processing insurance claims.
• Ensuring compliance with internal processes and regulatory standards, as well as adherence to company guidelines.
• Managing escalations to establish fair customer outcomes through defined escalation channels.
• Providing high-quality customer service by responding to claim-related inquiries and resolving disputes professionally.
• Training and mentoring claims agents and staff within the claims department to foster skill development and procedural adherence.
• Participating in audits and reviews to evaluate and improve departmental performance.
• Maintaining production output in alignment with business needs and departmental targets.

Scope and Dimension

Reporting directly to the GIH Senior Team Leader, this position includes direct line management responsibilities for a team of claims agents. You will collaborate closely with brokers, customers, and cross-functional teams, ensuring effective management of non-BAU claims activities. In addition to guiding daily tasks, you will provide mentorship and oversight to support claims agents’ development and ensure alignment with company objectives.

YOUR PROFILE
Experience and Knowledge Required:

• Proven experience managing claims processes and familiarity with non-standard claims tasks.
• Ability to review and analyse claims for validity and fair settlements, including high-cost and complex cases.
• Proficiency in implementing and managing procedures that enhance processing efficiency and ensure compliance with internal standards.
• Expertise in building effective relationships with brokers, underwriters, customers, and internal teams.
• Strong analytical skills to organise, prioritise, and meet deadlines in a fast-paced environment.
• Confidence in making informed decisions based on claim data and investigative insights.
• A professional approach representing the company to customers and external organisations, such as medical providers, underwriters, clinical teams, and senior leadership.

Skills:

• Strong verbal and written communication skills, with the ability to provide clear, professional responses to Members, Providers and Brokers
• Excellent organisational and prioritisation skills to meet strict deadlines.
• Ability to make sound decisions based on claims experience, research, and knowledge.
• Proficiency in mentoring and developing the skills of claims agents within the team.
• High attention to detail, with a focus on compliance and fair outcomes.
• Leadership skills, an ability to drive high perfromance outputs across your team in an enhaging and collabrative manner

Targets and Responsibilities:

• Maintain awareness of current company services, as well as changes in industry legislation or standards, and communicate relevant updates to your team.
• Adhere to and enforce company policies and procedures and take corrective actions in collaboration with HR where necessary.
• Set a positive example for teamwork, professionalism, and flexibility, ensuring support for the company’s service needs.
• Demonstrate professionalism in handling all colleague interactions and maintaining high standards in managing performance and conduct.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.