Here’s a polished version of the Customer Service Representative job description at Cigna Healthcare, making the responsibilities and qualifications clear and engaging:
Customer Service Representative – International Claims (Remote)
Your Role:
As a Customer Service Representative for international claims, you will be responsible for providing excellent support to stakeholders and providers, focusing on reconciliation-related claims. You’ll play a key role in managing claims, responding to inquiries, and ensuring that internal stakeholders have the accurate information they need. Your expertise and attention to detail will help resolve complex cases, involving collaboration with medical consultants, account managers, network managers, and legal advisors as needed.
Key Responsibilities:
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- Claims Management: Provide customer service for international claims, managing reconciliation-related files.
- Respond to Queries: Address incoming queries promptly via email, Salesforce, or other communication channels, providing clear, concise, and correct responses that are provider- and stakeholder-friendly.
- Escalation Support: Handle escalated claims or tasks from providers and internal stakeholders, offering expert advice as needed.
- Ownership of Complex Files: Take ownership of difficult or high-value files, ensuring they are resolved accurately and efficiently.
- Follow-up & Tracking: Monitor workload and ensure tasks are completed within agreed timelines. Follow up on unresolved files, ensuring targets are met.
- Communication: Tag the Customer Service Representative (CSR) in Salesforce and amend the status for communication to the provider as necessary.
- Procedural Improvement: Track and report procedural irregularities to Team Seniors for resolution.
- Team Collaboration: Maintain a cooperative and positive work environment, supporting colleagues and contributing to team success.
Your Profile:
- Educational Requirements: Minimum diploma or equivalent experience.
- Language Proficiency: Strong command of English (spoken and written). Additional languages are an asset but not essential.
- Medical Terminology: Knowledge of medical terminology is a plus.
- Technical Skills: Proficiency in Microsoft Office and proprietary IT applications. Familiarity with Salesforce is advantageous.
- Written Communication: Ability to convey messages in clear, precise language, paying attention to terminology and appropriate style.
- Customer Focused: Communicates empathetically, factually, and precisely with providers.
- Decision-Making: Skilled in making accurate decisions based on available information.
- Accuracy & Responsibility: Ensures accuracy in all tasks and follows through diligently and promptly.
- Efficiency: Balances quality and quantity in work output.
- Teamwork: Works well in a team environment, supporting colleagues to achieve shared goals.
- Computer Literacy: Quick to learn and utilize office applications and in-house systems.
- Confidentiality: Maintains discretion when handling sensitive or confidential information.
Our Offer:
- Challenging Role: A dynamic job in an international, growing company.
- Entrepreneurial Culture: A young, energetic company culture that values initiative and encourages professional growth.
- Global Impact: Be part of a team making a difference in healthcare, helping guide customers through the healthcare system.
About The Cigna Group:
At Cigna Healthcare, we are advocates for better health at every stage of life. Our mission is to empower customers with the information and insights they need to make informed decisions that enhance their health and vitality. As part of The Cigna Group, we strive to drive growth and improve lives worldwide.
This version focuses on clarity and organization while ensuring the role’s requirements and responsibilities are well communicated. It highlights the skills and competencies needed while providing a strong company profile. Would you like to adjust or add anything further?