Provider Reconciliation Representative

Cigna Job Specification

POSITION               : Customer Service Representative

REPORTING TO     : Supervisor

DEPARTMENT       :Customer Service

Career Band          : Band 1

YOUR ROLE

• Providing customer services for international claims for reconciliation related files.
• Responding to incoming queries in an appropriate and timely manner, advantage to have knowledge in SalesForce. Appropriate responses may require in-depth analysis and involve expert advice (Medical Consultant, Account Manager, Network Manager, Legal Advisor etc). An appropriate response is correct, clear, concise and provider & stakeholder friendly.
• Answering incoming tasks via queue from internal stakeholder, or those escalated by the providers for expert advice.
• Taking ownership of difficult or high-value files.
• Responding via the most efficient channel (e.g. e-mail, SF, etc).
• Following up on the individual workload and taking appropriate action when agreed targets are not met.
• Providing accurate file information to internal stakeholders where required.

Monitor all incoming Tasks for upload & ensure they are reviewed and acted on within 2 business days.

Tag CSR & amend the status in Sales Force is any communication needs to be done to the provider.

• Tracking procedural irregularities and raising these with the Team Seniors.
• Actively working to maintain a co-operative and friendly working environment.

YOUR PROFILE

• You have a minimum diploma or equal through experience.
• You have good knowledge of English (both spoken and written), any additional language is an asset but not essential.
• Medical terminology - added advantage.
• Use of necessary reference works.
• Knowledge of Microsoft Office and proprietary IT applications
• Written skills: conveys messages in clear language, paying attention to terminologies/circumstances

and appropriate style.

• Provider focused: communicates empathically, precisely and factually.
• Skilled decision-maker: takes the right action on allocated files based on the information available.
• Accurate: works accurately by giving complete and correct answers.
• Responsible: ensures that assigned contracts are followed up in a diligent, timely and accurate manner.
• Disciplined: follows procedures, agreements and document flows correctly.
• Efficient: able to strike the right balance between quality and quantity.
• Team-player: enjoys working as part of a team.
• Computer-literate: quick to learn current office applications and Cigna International in-house systems.
• Discrete: exercises utmost discretion when dealing with confidential (medical) information.

Our offer

• A challenging job in an international and growing enterprise.
• A dynamic, young and entrepreneurial company culture that values and stimulates initiative.

About The Cigna Group

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.