Posted:1 hour ago
By:Hiring Kenya
Company Details
Industry:
Insurance
Description:
Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Cigna has almost 40,000 employees who service over 80 million customer relationships around the world. Within its international division, a dedicated unit - headquartered in Belgium - focuses on the needs of International Organisations. This unit is specialised in servicing customers in remote areas as well as central hubs with five service centres in each time zone (Miami, Antwerp, Madrid, Nairobi and Kuala Lumpur) and local representations on every continent. When you work at Cigna, you can count on a different kind of career. >> Why join us? Healthy careers Cigna gives you the opportunity to grow and develop professionally and personally. Because we know our success begins with yours. Healthy returns We offer you monetary and non-monetary rewards. Our compensation is differentiated among employees based on responsibilities and performance. Healthy culture We stand
Job Description
Role summary
- The clinical value team is looking for 2 Medical Claims Review Senior Analysts (Band 3)
- As part of the Claims Review team you will be primarily responsible for the Medical Review, Coding, MNR and ICR of claims.
You will be:
- Interpreting key information from medical reports/invoices and translating this into medical coding in our hospitalization database and/or Salesforce application ‘Healthcloud’
- Analyzing invoices from providers all over the world to identify cost containment opportunities and you will be taking appropriate actions in line with our procedures to avoid unnecessary costs for our clients, members and Cigna
- Reviewing claims from a clinical point of view directly with Providers
- Collaborating with colleagues in different teams and roles (Claims Analysts, CSR’s, Doctors, Nurses etc) across the business while bridging cultural differences & backgrounds
- Attending weekly/Monthly/ad-hoc meetings with the team & supervisor to discuss and improve internal workflows and collaboration
- Serving as a contact person for other teams within Clinical and the wider business for expert advice on R&C calculations
- Taking ownership of your production making sure you meet the expected outputs
YOUR PROFILE
- Proficient in English
- Clinical Background (Nurse/Clinical officer)
- Passive knowledge of French/German/Italian. Additional languages is a plus
- Experience with processing provider claims is a plus
- Affinity with medical terminology is a plus
- ICD knowledge is a plus
- Communicative and not afraid to approach people
- Proactive and driven
- You can deal with integrity
- Tech savy, not afraid to work in/with different systems/applications at the same time
- Eye for detail and love for accurateness
- Flexible with the ability to shift priorities when required
- Not afraid of moving forward in the midst of ambiguity
Salary: Discuss During Interview
Education: Diploma
Employment Type: Full Time
