About Cigna

Cigna, a Fortune 500 company, is a global health service company dedicated to helping people improves their health, well-being and sense of security.

For more than 200 years, Cigna and its predecessor companies have been in the insurance field. In 1792, a group of Philadelphia citizens formed the Insurance Company of North America (INA), the first marine insurance company in the United States. Now, China has become the headquarters of Asia Pacific GHB (Global Health Benefits) business.

We make this happen through a broad range of integrated health care and related plans and services, and proven health and wellbeing programs that are targeted to the unique needs of our customers, clients and partners.

"At Cigna, we understand that people are unique, and so, too, is their health. In a world of many millions, we see each person defining a healthy life on his or her own terms. It's our aim to be part of that journey, helping
people achieve better health and peace of mind along the way."
- David Cordani, CEO

世界五百强公司信诺是一家致力于帮助人们改善健康,幸福,和安全感的全球健康服务公司.
信诺和它的前身已经在保险业立足了两百多年.现在中国已经成为信诺亚太地区高端健康医疗保险业务的总部.并且在这个领域市场份额第一。
我们是通过 一系列的综合保健和相关的计划,服务,以及证实过的致力于满足我们客户和合作伙伴独特需求的健康和幸福项目来实现的.
“在信诺,我们知道每个人都是独一无二的,他们的健康也是如此. 大千世界, 我们发现每个人用他自己的方式定义健康的生活. 我们的目标就是参与其中, 帮助人们在一生中达到更好的精神上的健康和安宁.
想要了解更多关于信诺的信息,请访问信诺官网www.cigna.com

CDSS JOB DESCRIPTION

1 Identification
Opening: Group Claims Intern 理赔专员
Reporting to: Group Claims Team Leader

2 Purpose of the job/key objective

To provide high levels claims to international or domestic clients, recognising that service is the primary differentiator for CIGNA in provision of healthcare coverage to high end customers (expatriate employees, local executives etc).

3 Main duties/Responsibilities (list no more than ten items)

? Adjudicate claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals.
? Monitor turnaround times to ensure claims are settled within required time scales, highlighting when this is not achievable.
? Monitor and highlight high cost claims and ensure relevant parties are aware.
? Provide GOP (Guarantee of Payment) as required to clients and providers.
? Interface effectively with internal and external customers to resolve customer issues.
? Actively support all team members and provide resource to enable all operational goals to be achieved
? Performance metrics will increase over time with proficiency and complexity of work. Initial productivity will require accurate response or completion of 40-50 claims/day.
? Meet or exceed Service level agreement requirements. Minimally set at a 10 day turnaround for claims or in accordance with client specific requirements. This number will be reviewed periodically and can be increased or decreased based on business need.
? Quality standards for claims will be developed, communicated and meeting them will be part of the production requirement.
? Financial accuracy of 99% for coding and payment of claims

4 Scope and Dimensions
? Report to Line Management
? Responsible for all claims regarding group members.

5 Experience and Skills Required
? Fast learning skills, strong adaptability
? Sense of team work and customer service
? Solid knowledge of basic Microsoft applications to include Word, Excel and MS Outlook. PowerPoint is desirable but not required.
? English and Mandarin fluency – spoken, written, reading

6 Education/professional qualifications required
? Senior student in University
? At least 3 days/week on-site work at the office
? Major in English, Foreign Trade, Nursing, Insurance or Polytechnic



CDSS JOB DESCRIPTION


1 Identification
Opening: Group CSR (Customer Service Representative) Intern 电话客服专员
Reporting to: Group CSR Team Leader
2 Purpose of the job/key objective

To provide high levels customer service to international or domestic clients, recognising that service is the primary differentiator for CIGNA in provision of healthcare coverage to high end customers (expatriate employees, local executives etc).

3 Main duties/Responsibilities (list no more than ten items)

? Answer the calls from the customers or providers, respond accurately within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible.
? Monitor turnaround times to ensure the inquiry emails are replied within required time scales, highlighting when this is not achievable.
? Make appointment for the visit, provide GOP (Guarantee of Payment) and COC (Certificate of Coverage) as required to clients and providers.
? Interface effectively with internal and external customers to resolve customer issues.
? Actively support all team members and provide resource to enable all operational goals to be achieved.
? Meet or exceed Service level agreement requirements. Minimally set at a 5% abandon ratio for in-bound calls or in accordance with client specific requirements. This number will be reviewed periodically and can be increased or decreased based on business need.
? Quality standards for both call and email will be developed, communicated and meeting them will be part of the production requirement.
? To ensure that all faxes are sent in time and keep an up-to-date register, distributing incoming faxes quickly and efficiently.

4 Scope and Dimensions
? Report to Line Management
? Responsible for all calls, emails and complaints regarding group members.

5 Experience and Skills Required
? Fast learning skills, strong adaptability
? Sense of team work and customer service
? English and Mandarin fluency – spoken, written, reading
? Solid knowledge of basic Microsoft applications to include Word, Excel and MS Outlook. PowerPoint is desirable but not required.

6 Education/professional qualifications required
? Senior student in University
? At least 3 days/week on-site work at the office
? Major in English, Foreign Trade, Nursing, Insurance or Polytechnic

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