Jobs / Malaysia / Cigna Health And Life Insurance Company
Claims Representative, GEH APAC - Cigna Healthcare
Cigna Health And Life Insurance Company · 🌍 Kuala Lumpur, Malaysia
Sponsorship verdict
No sponsorship evidence yet
No government record and no wording either way. Not a refusal — ask the recruiter.
- No government sponsor record hereNo government sponsor record covers this employer in this country.
- The posting doesn’t mention sponsorshipSilence isn’t a refusal — ask the recruiter before investing much time.
- Can’t check pay against the visa rulesWe don’t have visa salary rules for this country yet.
- Confirmed live todayWhen a source last listed this job as open.
A verdict summarises public evidence; it is not legal advice and never a guarantee — the employer and the immigration authority decide. Sign in to factor in where you can already work.
Or apply yourself on the official page →
Why not apply?
No register record and no sponsorship wording in the posting. Worth asking the employer before investing significant time.
SponsorApply flags time-wasters so your applications go where they can land. These come from the posting's own wording — read the original listing to confirm. See better-fit alternatives →
Sponsor Radar — Cigna Health And Life Insurance Company
No government sponsor record covers this employer in this country.
Past sponsorship or register membership never guarantees sponsorship for this vacancy or for you. Full Sponsor Radar for Cigna Health And Life Insurance Company →
About the role
1. JOB PURPOSE The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain pre-approvals and claims processing as per the defined terms and policies of the organization. 2. RESPONSIBILITIES AND DUTIES · Processes claims from members and providers. · Assists queries from providers and payers via phone calls or e-mails. · Maintains files for authorizations and other reports. · Assesses and processes claims in line with the policy coverage and medical necessity. · Be fully versed with medical insurance policies for various groups / beneficiaries. · May assist in training colleagues and asked to share knowledge. · Accurately assesses eligibility within the policy boundaries. · Monitors and maintains the claims processing as per the defined terms and policy of the organization. · Achieves required processing targets assigned by the team leader on daily, weekly and monthly basis. · Monitors the qualitative and quantitative measures for claims & pre-approvals. · Ensures compliance to any changes in terms of system parameters or process. · Maintains quality as per framework for accuracy. · Maintains productivity and responsiveness to the work allocated. · 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). · Assessing and processing claims for medical expenses while always bearing in mind the importance of medical confidentiality. · Accurate data input to the system applications. · Positioning him/herself analytically and critically in the context of cost management and in respect of existing working methods. · Following up 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. · Monitor and highlight high-cost claims and ensure relevant parties are aware. · Follow Claim Manual and SOP strictly, adjudicate claims according to benefit policies, and meet both financial/procedure accuracy and TAT target on claims adjudication. · Adjust error claims according to actual situation. · Well handle recoupment and reconciliation work, communicate with providers and members via call and email for collection and explanation. · Work with cross function teams, such as Finance, CSR, Eligibility, Network, Client Management, etc. Ensure recoupment work go smoothly. · Actively support Team Leader and work with claim colleagues to enable all operational goals to be achieved 3. KNOWLEDGE, SKILLS AND EXPERIENCE · At least 1-2 years of experience performing a similar role. Fresh graduates are highly encouraged to apply. . Graduate with a medical or science degree. · 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 procedure. · Strong administration awareness and experience, essential. · Strong skills in Microsoft Office applications, essential. · First class written and verbal communication skills, essential. · Ability to com