Medical Claims Review Analysts - IP
At a Glance
- Category
- 🏥 Healthcare
- Level
- Mid-Level
- Type
- Full-time
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To assist the IP department in finalizing cases by medically scrutinizing and justifying the prescribed treatment or service in addition to finalize assigned cases of claims and pre-authorization requests. He/She should maintain IP pre-approvals and claims processing and adjudication cycle within NHS software systems as per the defined terms and policies of the organization; He/ She will be guided by the regulations laid down by the regulatory authorities such as MoH, DHA or others.
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.
Requirements
- •Ability to medically scrutinize and justify prescribed treatments or services
- •Knowledge of regulations laid down by MoH, DHA, or other regulatory authorities
- •Ability to maintain pre-approvals and claims processing cycles
Responsibilities
- •Finalize assigned cases of claims and pre-authorization requests
- •Maintain IP pre-approvals and claims processing and adjudication cycle within NHS software systems
- •Ensure compliance with defined terms and policies of the organization
- •Adhere to regulations laid down by regulatory authorities such as MoH, DHA
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Cigna offers health insurance, pharmacy benefit management, and related services. It serves individuals, employers, and government organizations worldwide.