Job Description

•Determine customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented.

•Assess medical appropriateness of claims submitted, and adjust claims as needed.

•Pay all covered claims accurately and timely.

•Execute on all client and provider SLA agreements.

•Attain individual and team quality and productivity targets.

•Manage both new claims and open claims equally and maintains decision turnaround times.

•Understand Cigna Operations and Corporate Compliance, Polices and Procedures and best practices.

•Stay abreast of ongoing trainings associated with role and business unit objectives.


•Can speak and understand Chinese/Mandarin language. •Excellent attention to detail, quality and accuracy is essential. •Excellent organizational, workload and time management skills are essential. •Able to work within tight timeframes to achieve challenging objectives and TAT’s is essential. •Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset. •Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitors simultaneously. •Proficiency with MS Office applications are required (Word, Outlook). •Strong written communication skills demonstrated in previous work experience. •Experience in effectively meeting/exceeding individual professional expectations and team goals. •Demonstrated analytical and basic math skills.

All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.

Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.

Accenture is committed to providing veteran employment opportunities to our service men and women.

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