Job Responsibilities

• Handle pre-approval of commercial assessment

• Handle claims process, including both inpatient and outpatient medical claim

• Communicate with customer on pre-approval decision

• Improve the effectiveness of the claim adjudication and administration processes, with network service providers when necessary

• Handle provider claim enquiries from panel network

• Prepare report to management

• Conduct claim assessment processes, claim investigation and to review all status and ensure efficient outcome in customer oriented approach

• Meet standard of individual quality, turnaround time and productivity benchmark.

• Handle project tasks and arrangement

Requirements

• Diploma or above, preferably with insurance-related qualifications, e.g. FLMI, ICA

• At least 3 years’ experience in claims adjudication / administration

• Experience in working with pre-approval of medical claims

• Good team player, able to work independently and under pressure in a fast-paced environment

• Possess customer centricity mindset

• Good interpersonal and communication skills

• Cantonese speaker with good command of both English and Chinese

About The Cigna Group

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.