Provider Reconciliation Representative

at  The Cigna Group

CIGNA JOB SPECIFICATION

POSITION : Customer Service Representative
REPORTING TO : Supervisor
DEPARTMENT :Customer Service
Career Band : Band 1

• Providing customer services for international claims for reconciliation related files.
• Responding to incoming queries in an appropriate and timely manner, advantage to have knowledge in SalesForce. Appropriate responses may require in-depth analysis and involve expert advice (Medical Consultant, Account Manager, Network Manager, Legal Advisor etc). An appropriate response is correct, clear, concise and provider & stakeholder friendly.
• Answering incoming tasks via queue from internal stakeholder, or those escalated by the providers for expert advice.
• Taking ownership of difficult or high-value files.
• Responding via the most efficient channel (e.g. e-mail, SF, etc).
• Following up on the individual workload and taking appropriate action when agreed targets are not met.
• Providing accurate file information to internal stakeholders where required.
  Monitor all incoming Tasks for upload & ensure they are reviewed and acted on within 2 business days.

Tag CSR & amend the status in Sales Force is any communication needs to be done to the provider.

• Tracking procedural irregularities and raising these with the Team Seniors.
• Actively working to maintain a co-operative and friendly working environment.