Administrative Services Representative

About Us

At CIGNA Healthcare we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities, and shareholders every day.

One of the keys to driving Responsible Growth is being a great place to work for our teammates around the world. We're devoted to being a diverse and inclusive workplace for everyone. We hire individuals with a broad range of backgrounds and experiences and invest heavily in our teammates and their families by offering competitive benefits to support their physical, emotional, and financial well-being.

CIGNA Healthcare believes both in the importance of working together and offering flexibility to our employees. We use a multi-faceted approach for flexibility, depending on the various roles in our organization.

Working at CIGNA Healthcare will give you a great career with opportunities to learn, grow and make an impact, along with the power to make a difference. Join us!

Job Title : Administration and Queue Specialist

Department : GIH

Reports To : Senior Team Leader

Job Summary

We are seeking a highly organized and detail-oriented Administrative Specialist to join our growing team. In this role, you will play a crucial role in ensuring the smooth and efficient case management. Your primary responsibilities will include triaging cases, accurately routing them to the appropriate queues, and verifying case alignment with relevant policies and entities. Additionally, you will be responsible for the efficient allocation of work to the claims / customer services team based on TAT.

Key Responsibilities

• Accurately assess and categorize cases based on their nature and urgency.
• Sorting, processing, and vetting of claims firsthand for claims payment and ensuring they are accurately assigned.
• File management and classification of data and supporting reporting compilation.
• Electronic transfer of received claims to the various platforms.
• Route cases to the correct queues within the case management system.
• Ensure efficient and timely case assignment to the appropriate claims handlers.
• Verify that each case is handled in accordance with established company policies and procedures ensuring there are no data breaches.
• Identify and escalate any potential policy exceptions or discrepancies.
• Monitor case volume and workload within the claims team.
• Maintain accurate and up-to-date records within the system.
• Generate reports and analyse data as needed.
• Collaborate effectively with other departments within the organization.
• Identify opportunities for process improvement within the case management workflow.
• Participate in team meetings and contribute to discussions on improving team efficiency and effectiveness.

Requirements

Education : Any Graduation.

Job Location : Bangalore

Weekend availability may be required

Holiday support as required.

Note : This job description is intended to provide a general overview of the position. It is not intended to be an exhaustive list of duties and responsibilities.

Disclaimer

This job description may be subject to change at any time due to business needs.

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.

Skills Required

case management software , Microsoft Office Suite