# Claims Processor

**Company**: Cigna Healthcare
**Experience**: mid
**Job type**: full-time
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cigna.wd5.myworkdayjobs.com/en-US/cignacareers/job/Kuala-Lumpur-Malaysia/Claims-Representative--GEH-APAC-_26011799?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_5fbf7b9d-030

## Description

We are seeking a Claims Processor to join our team. As a Claims Processor, you will be responsible for serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests, and maintaining databases.

**Responsibilities and Duties**

- Process claims from members and providers

- Assist queries from providers and payers via phone calls or emails

- Maintain files for authorizations and other reports

- Assess and process claims in line with policy coverage and medical necessity

- Be fully versed with medical insurance policies for various groups/beneficiaries

- May assist in training colleagues and sharing knowledge

- Accurately assess eligibility within policy boundaries

- Monitor and maintain claims processing as per defined terms and policy of the organization

- Achieve required processing targets assigned by the team leader on daily, weekly, and monthly basis

- Monitor qualitative and quantitative measures for claims and pre-approvals

- Ensure compliance with changes in system parameters or processes

- Maintain quality as per framework for accuracy

- Maintain productivity and responsiveness to allocated work

- Collaborate with other stakeholders/teams to resolve queries, including complex queries

- Actively support all team members to enable operational goals to be achieved

- Meet or exceed Service Level Agreement requirements, team KPI(s), monthly quality audit scores, and NPS (Net Promoter Score)

**Requirements**

- At least 1-2 years of experience performing a similar role

- Experience working for an international company preferred but not essential

- Claims processing or insurance experience preferred but not essential

- Broad awareness of medical terminology advantageous

- Excellent organizational skills, capable of following and contributing to agreed procedures

- Strong administration awareness and experience essential

- Strong skills in Microsoft Office applications essential

- First-class written and verbal communication skills essential

- Ability to communicate across a diverse population essential

- Capable of working independently or as part of a team

- Good time management, ability to work to tight deadlines

- Flexible and adaptable approach, sometimes working in a fast-paced environment

- Passion for achieving agreed objectives

## Skills

### Required
- Microsoft Office
- claims processing
- medical insurance policies
- communication skills
- organizational skills
- time management

### Nice to have
- international company experience
- claims processing experience
- medical terminology

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Source: [Apply at cigna.wd5.myworkdayjobs.com](https://cigna.wd5.myworkdayjobs.com/en-US/cignacareers/job/Kuala-Lumpur-Malaysia/Claims-Representative--GEH-APAC-_26011799?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)