Act as a Subject Matter Expert for IOH Provider Claims, focusing on process improvement, financial verification, and quality audits. Lead the training and onboarding of new hires while monitoring team performance and resolving escalated cases.
The job profile for this position is Claims Analyst, which is a Band 2 Senior Contributor Career Track Role.
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As an SME you will support Supervisor and Senior Supervisor in your relevant process.
Key to the role will be building/maintaining an in depth knowledge of (part of) the process to continuously improve the processes and share that knowledge to deliver a high quality customer centric service offering. Your role includes:
- Building and maintaining a solid in depth knowledge in (part of) your process
- Being an expert user of any of the used tools within the team and/or any of the partner set-ups in place.
- Being the organizational ambassador for your knowledge area within your own team and across the wider organization. You are the go to person in case of questions on your area of expertise.
- In that role, being able to represent the Process / Organization in (enterprise wide) projects, stakeholder meetings, or act as a relationship manager towards some of our (internal/external) strategic partners or act as a trainer.
- Being proactive in identifying improvement/enhancement opportunities and be active in seeking and sharing ideas for innovation in business processes.
- Striving to provide excellent service to our Providers, Members and Clients.
- Playing an active role in a culture of continuous improvement.
- Review available documentation on knowledge management tool. Create new documents and amend existing ones according to business needs. Remove obsolete documentation.
- Taking ownership of any escalated cases and providing updates to the Supervisor on any issues.
- Taking ownership of solving any issues (if applicable) in your area of expertise.
- Proactively addressing and/or escalating any risks.
- Developing/maintaining proactive/effective business relationships, internally, externally and with BPO partner to ensure a seamless delivery of service.
- On-site training and support for new hires.
Specific for IOH Provider Claims SME’s:
- Support the financial verification of the team, including approval of manual payments.
- Support of quality audits (financial verification + extra verification) with a clear focus on the financial and procedural accuracy company KPI’s. You document your findings, share them with the supervisor and you discuss corrective actions on individual and team level with the Supervisor.
- Responsible to provide training on specific topics where you act as a subject matter expert, be it a process or a client, including the lead of the training organization and coordination.
- Lead the onboarding and training phase of newbies, or colleagues taking up new accounts, including their performance reporting.
- Monitoring team performance, such as Quality results, PWB follow up and CRM tasks. Analyzing issues' root cause and propose/ implement relevant actions to improve results with the support of Senior Supervisor.
YOUR PROFILE
- Strong performance track record.
- International mind-set, with holistic and able to work remotely with peers across locations.
- 1 year of experience working at Cigna.
- Claims IOH processes experience.
- Fluency in English.
- Good communication skills, and knowledge of Window tools, e.g. Excel, PowerPoint, Windows.
- A growth mindset with a positive attitude towards change and the ability to play an active role in implementing change initiatives within your own process.
- Action-orientated problem-solving attitude.
- Able to seek out best practice in order to effectively deal with diverse, complex and highly sensitive issues.
- Accountability – assume ownership for achieving personal results and collective team goals.
Please include your CV and cover letter in the application.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.