KEY AREAS:
Processes Guarantee of Payments (GOPs) and takes ownership of cases as required. The Guarantee of Payment is a confirmation towards the hospital regarding length of admission, treatment and insured amount.
Works on sensitive/escalated cases as required.
Follows established departmental policies and procedures to process & triage GOPs.
Liaises with hospitals in case additional info is needed.
Negotiates discounts with providers.
Steers member to alternative providers.
Liaises and ensures efficient coordination with the medical/case management teams.
Works independently and effectively communicate to internal and external customers by telephone and email.
Maintains accurate workflow and process documents.
Translates and interprets medical and other relevant documents when needed.
SKILLS:
Advance or bilingual knowledge of English is a must (C1/C2)
Advance knowledge of one or more of these languages: French, German, Portuguese or any other European language (C1 Level).
What you’ll bring:
Customer focused with ability to identify and solve problems.
Customer centric mind-set.
Exceptional interpersonal skills with good verbal and written communication.
Ability to organise, prioritise and manage workload to meet individual and team targets.
Ability to quickly identify customer needs and exercise judgment in a professional and confident manner.
Must possess excellent attention to detail, with a high level of accuracy with proactive approach.
Capable of balancing various tasks at once while achieving deadlines.
Ability to work under own initiative and proactive in recommending and implementing process improvements.
Apply via :
cigna.wd5.myworkdayjobs.com