PSO Claims Representative

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Dimo’s Place, KEN
In-Office
Healthtech • Insurance
The Role

The job profile for this position is Claims Representative, which is a Band 1 Professional Career Track Role.

YOUR JOB

As a Claims Representative you will be handling multiplatform processing and adjusting of claims. You will report directly into the supervisor and will work closely with your peers in the same as well as others locations across the globe. Key to the role will be critical analysis, processing and adjusting of claims for medical expenses within the fixed turn-around time and with high the established quality standards. Your role includes:

Job Profile:

Claims processing

  • Assessing, processing and adjusting of claims for medical expenses while always bearing in mind the importance of medical confidentiality.

  • Accurate data input to the different systems applications.

  • Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods.

  • Following up his/her own workload (volume and timing): keeping an eye on chronology and processing time of the work volume and taking suitable actions.

  • Participate efficiently in processing the flow of claims: inform the Supervisor about claims lacking clarity and about possible ways of optimizing the processes.

  • A sustained effort towards high-quality claims handling, accurate reimbursements and fast transactions are important motivators.

In relation to other positions:

  • Providing accurate communication about a dossier to the interested internal employee.

  • Tracking irregularities in procedures and highlighting these to the Supervisor.

  • Raising problems or sensitivities with your supervisor.

  • Participating actively in an agreeable and amicable atmosphere.

  • Any other duty as assigned by the supervisor.

YOUR PROFILE/SKILLS

Education Level

  • Diploma or Bachelor Degree in Business related field

Specific Knowledge

  • Active knowledge of English

  • Active/passive knowledge of other languages is an added advantage (French, Portuguese, Spanish, German, Arabic languages)

Skills

  • Skillful in taking decisions: takes the right action on allocated files based on the available information.

  • Skillful with numbers: likes to work with numbers.

  • Flexible: is able to adapt to the changes easily;

  • Multitasking: works easily in different systems at the same time;

  • Accurate: works accurately on the input of data, aims to work faultlessly.

  • Discipline: pays attention to procedures, agreements and document flows.

  • Efficient: finds a good balance between quality and quantity.

  • Team player: Able to work in a team.

  • Skillful with computer programs: readily learns the ropes in the use of current office applications and own Cigna International systems.

  • Discreet: works discreetly with confidential (medical) information.

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.

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The Company
HQ: Bloomfield, CT
74,000 Employees
Year Founded: 1982

What We Do

At Cigna, we're more than a health insurance company. We are your partner in total health and wellness. And we’re here for you 24/7 – caring for your body and mind. As a global health service company, Cigna's mission is to improve the health, well-being, and peace of mind of those we serve by making health care simple, affordable, and predictable. Our values are the core of our culture. Our values guide how all 74,000 of us around the world work together, serve our customers, patients, clients, communities, and deliver on our mission.

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