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    Job Openings - Toronto, ON, Canada - Cigna

    Cigna
    Cigna Toronto, ON, Canada

    3 weeks ago

    Default job background
    Description

    Job Description:

    This department is responsible for investigating and responding to inquiries, and updating process documents to support the health claim verification function. Health Claims Administration is also responsible for updating healthcare plans set up according to customer request and design.

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    Job Responsibilities:

    • Track key metrics for reporting, communication, forecasting, staffing and submit daily, weekly or monthly reports as required
    • Work with internal and external partners to manage and respond to customer and quality inquiries within service level standards. Handle high priority escalations.
    • Support internal Express Scripts Canada departments which rely on the daily operations of Claims Services
    • Handling of special projects as assigned
    • Maintain administrative process documents and ensure updates to processes are documented within service level standards
    • Responsible for monitoring all filing on/off site (Iron Mountain Storage)
    • Supervise, lead and develop a team of Claims Processors through workload management, regular 1:1 meetings, performance coaching and goal progress and outcomes check in's
    • Manage the day-to-day claims processing operation according to established performance standards and documented NIHB policies and procedures for both French and
    • English health claims processing services
    • Ensure claims turnaround time and productivity objectives are met based on service level standards
    • Ensure that team members are efficiently trained and provided with the appropriate tools to perform their jobs
    • Track monthly Key Performance Indicators (KPI's) statistics on turnaround times (TAT's)
    • Work proactively to identify process improvements around productivity, quality and training
    • Identify operational risks and present solutions for optimizing results

    Job Requirements:

    • Ability to adapt and prioritize workload
    • Working knowledge of Microsoft Office Suite of tools (Word, Excel, Outlook)
    • Excellent organization and planning skills
    • Strong communication and presentation skills
    • Proven ability to identify opportunities for improvement and development of new ideas
    • Proven analytical, decision-making skills and ability to think strategically
    • Bachelor's degree or related job experience
    • A minimum of 3-5 years experience in group claims adjudication with a focus on health claims administration with related leadership experience
    • Strong time management skills and ability to work under tight deadlines
    • Demonstrated focus on quality customer service
    • Must be Bilingual (French/English)
    • Proven people management/leadership skills – ability to build strong diverse teams
    • Ability to coach/train, give and receive feedback in a constructive manner

    Job Details:

    Company: Cigna

    Vacancy Type: Full Time

    Job Location: Toronto, ON, CA

    Application Deadline: N/A

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