Description
Cigna Healthcare is seeking an Access to Care Specialist to play a key role in helping customers access the healthcare services they need.
You will coordinate care journeys, manage pre-authorisation and Guarantee of Payment requests, and work closely with customers, healthcare providers, medical teams, and internal partners to deliver timely, high-quality outcomes.
Responsibilities
- Take ownership of healthcare cases from initial contact through to resolution, ensuring customers receive timely support and guidance throughout their treatment journey.
- Deliver a positive customer experience by clearly explaining benefits, coverage, exclusions, and next steps, while providing regular updates on case progress.
- Coordinate treatment arrangements and collaborate with healthcare providers to obtain medical information, treatment plans, and cost estimates.
- Review and process pre-authorisation requests and Guarantee of Payment documentation within agreed service standards.
- Promote appropriate use of in-network providers and support cost-containment initiatives while maintaining excellent customer outcomes.
- Build effective relationships with customers, healthcare providers, Medical Advisors, Clinical teams, and internal stakeholders to ensure seamless care coordination.
- Maintain accurate documentation, comply with regulatory and policy requirements, and contribute to continuous improvement initiatives that enhance service quality and efficiency.
Requirements
- Experience in customer service within healthcare, insurance, medical assistance, or a related environment.
- Experience managing customer cases from initiation through to resolution.
- Ability to interpret policy information, benefits, and coverage details accurately.
- Experience working to service levels, quality standards, and customer-focused performance measures.
- Ability to manage multiple priorities and make sound decisions when handling complex cases.
- A commitment to delivering high-quality customer service while maintaining attention to detail and accuracy.
Skills
- Soft Skills: Customer service and relationship-building skills, Strong verbal and written communication, Problem-solving and decision-making ability, Organisation and time-management skills, Empathy and emotional intelligence, Ability to work independently and collaboratively, Adaptability in a changing operational environment.
- Technical / Functional Skills: Case management and care coordination, Pre-authorisation processing, Guarantee of Payment (GOP) administration, Healthcare benefit and policy interpretation, Documentation and record management, Stakeholder and provider management, Regulatory and compliance awareness.
- Nice to Have: International health insurance experience, Knowledge of pre-authorisation and GOP processes, Healthcare, insurance, or medical administration qualification, Experience working with global healthcare providers.
Benefits
- Competitive salary and benefits package.
- Multicultural and hybrid working environment with opportunities to collaborate across international teams.
- Private Medical Insurance and Employee Wellbeing Benefits to support your health and wellbeing.
- Educational Development Program to help you continue learning and growing your career.
- The opportunity to make a meaningful impact by helping customers access the right care at the right time.