Eligibility Representative

Job Description :

The job holder is responsible for member level details in the internal system. He/she will be responsible for any endorsement requests, queries and issues related on member level to be completed within the agreed turnaround time.Working directly with client managers (new & retention) on membership list & validating with Yakeen to achieve 100% upload within 48 hours & minimizing fallout below 1% (excluding duplicate insurance) after client confirmation.

Responsibilities :

- Handle day to day activities related to Member endorsements Addition

Deletion, Update requests.
- Validate and process requests as per Regulatory Guidelines.
- Standard Operating Procedures and Business Processes in line with agreed KPI/TAT.
- Upload member documents in Compliance repository for future audit and review.
- Acknowledge and confirm completion of requests via ticketing portal.
- Fallouts & Duplicate Insurance: Working directly with clients to manage fallouts & arrange compliance information for successful CHI upload.
- Policy validation: Arranging required compliance documents & information to confirm policy validation.
- Misc : Any related tasks on membership/policy assigned by Manager.

Qualifications:

• Bachelor’s or Diploma degree in related field.
• Minimum of 1 TO 3 years of experience with data entry, preferably in Medical Insurance
•  Analytical skills – must be able to review data and identify any potential issues or discrepancies
• Must be able to conduct computer data entry. & skilled in micro-office.
•  Excellent written and oral communication skills in both Arabic and English
•  Proven ability to work independently as well as a productive member of a team.
•  Exceptional organization and time-management focus.Person specification:

• Conflict Management – Sees opportunities within conflicts arising; reads situation quickly; engages in focused listening; can hammer out tough agreements and settle disputes equitability; can find common ground and get cooperation with minimum disruption.
•  Customer Focus – Is dedicated to meeting the expectations and requirements of internal and external customers; Gets first-hand customer information and uses it for improvements in products and services; Acts with customers in mind; Establishes and maintains effective relationships with customers and gains their trust and respect
• Dealing with Ambiguity - Can effectively cope with change; can shift gears comfortably. Can decide and act without having the total picture. Doesn’t have to finish things before moving on. Can comfortably handle risk and uncertainty.
• Interpersonal Savvy - Relates well to all kinds of people—up, down, and sideways, inside and outside the organization; Can build appropriate rapport, constructive and effective relationships. Can diffuse even high-tension situations comfortably.
• Learning and Applying quickly – Learns quickly when facing new problems; open to change. Analyzes both successes and failures for clues to improvement. Experiments and will try anything to find solutions. - Organizing - Can orchestrate multiple activities at once to accomplish a goal. Uses resources effectively and efficiently. Arranges information, emails and other files in a useful manner. -About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourselfEMEA cigna.com for support. Do not email SeeYourselfEMEA cigna.com for an update on your application or to provide your resume as you will not receive a response.