Claims Representative at Cigna

Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the world. Within its international division, a dedicated unit - headquartered in Belgium - focuses on the needs of International...

 

Claims Representative

  • Job TypeFull Time
  • QualificationBA/BSc/HND , Diploma
  • Experience
  • LocationNairobi
  • Job FieldInsurance 

Main Duties / Responsibilities

  • As Claims Representative you analyze claims in respect of client medical costs.
  • You adjudicate medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
  • You analyze reimbursements according to the contract agreements and assess, code and calculate them using a computerized claims processing system.
  • You pass communications to the communication team to solve or preempt any possible issues with your stakeholders.
  • Monitor turnaround times to ensure your claims are settled within required time scales, highlighting to your supervisor when this is not achievable.
  • You take responsibility/ownership of complex cases. You handle them accurately and with the personal attention that is required.
  • You keep your knowledge up to date with respect to the medical information necessary for handling claims and you take part in trainings to ensure you are up to date with policies, processes and other required information.
  • You are attentive to inaccuracies in the files and communicate them to your team leader/departmental head.
  • 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.
  • Carry out other adhoc tasks as required in meeting business needs.

Claims Processor Requirements:

  • Knowledge in claims processing
  • French language is an added advantage.
  • Diploma or degree in a related field.
  • You are prompt, precise and good with numbers.
  • A first experience in analytical work is a plus.
  • You have an eye for detail and you are known to work meticulously.
  • You can work individually and make correct decisions, always keeping customer centricity as guiding principle through everyday work.
  • You are flexible and quickly adapt to ever-changing work processes.
  • You are aware of the sensitivity and delicacy of the information you handle.
  • You are proactive, ensuring a smooth workflow and taking into account the needs of your client.  
  • You are a team-player, sharing best practices on processes and procedures with your colleagues.
  • You can familiarize yourself quickly with computer applications.

Check how your CV aligns with this job

Method of Application

Interested and qualified? Go to Cigna on cigna.wd5.myworkdayjobs.com to apply

Comments

Post a Comment

Popular posts from this blog

Customer Support Representative at BasiGo

BasiGo is an e-mobility start-up looking to revolutionize the public transportation sector by providing public transport bus owners with a cost-effective electric alternative to diesel. Headquartered in Nairobi, Kenya, our team is strategically composed of seasoned entrepreneurs who have spent over a decade working and innovating within electric vehicle t...   Customer Support Representative Job Type Full Time Qualification BA/BSc/HND , Diploma Experience Location Nairobi Job Field Customer Care  About the role:  We are looking for Customer Support Representatives (CSR) to assist our customers with technical problems when using our products and services. You will be the primary point of contact for our customers and coordinate with all BasiGo departments to ensure that issues are resolved within SLA and customers are communicated promptly.  To be successful in this role, you should be an excellent communicator who easily gains client trust. You should ...
Read more

Direct Sales Representative - Coast Region at KCB Bank Kenya

Kenya Commercial Bank Limited is registered as a non-operating holding company which started operations as a licensed banking institution with effect from January 1, 2016. The holding company oversees KCB Kenya - incorporated with effect from January 1, 2016 - and all KCB's regional units in Uganda, Tanzania, Rwanda, Burundi, Ethiopia and South Sudan. It als...   Direct Sales Representative - Coast Region Job Type Full Time Qualification BA/BSc/HND Experience 2 years Location Nairobi Job Field Sales / Marketing / Retail / Business Development  KEY RESPONSIBILITIES Sourcing prospective customer leads from various sources, such as referrals, cross-selling opportunities, sales activations organized by the bank, or sales leads provided by the bank.     Explaining the features of the products to prospective customers in line with product features and Treating Customers Fairly Guidelines provided by the bank.     Guiding customers on how to fill in applications f...
Read more

Regional HR Administrator at a Multinational Organization

Regional HR Administrator Job Type Full Time , Onsite Qualification BA/BSc/HND Experience 3 - 5 years Location Nairobi Job Field Human Resources / HR  Salary Range KSh 100,000 - KSh 150,000/month Job Summary:  The Regional HR Administrator will support and coordinate HR operations across assigned regions, ensuring efficient delivery of HR services in recruitment, onboarding, payroll administration, employee relations, performance management, and compliance. This role plays a critical part in maintaining accurate HR records, supporting managers and employees, and ensuring alignment with company policies and local labor laws.  Key Responsibilities  HR Operations & Administration   Support end-to-end HR processes across the region, including recruitment, onboarding, confirmation, and exits.  Maintain accurate and up-to-date employee records and HR documentation.  Coordinate payroll inputs, benefits administration, and statutory compliance wi...
Read more