Provider Inquiry Coordinator

1 month ago

Nairobi, Nairobi Area, Kenya Cigna Full time

Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security.

Cigna has almost 40,000 employees who service over 80 million customer relationships around the world
Summary

Delivers best in class service to HCP by handling daily queries, escalations, complaints, reconciliations and suspensions. Analyses root causes in order to correct deviations and implement initiatives to improve service delivery.

Closely collaborates with provider network team and other key stakeholders to coordinate actions, projects and improvement plans aimed to improve member and provider experience.

About Job

As a Provider Inquiry Coordinator (PIC) you will be part of Provider Relations Team embedded into the Provider Services Organization, being responsible for escalation, reconciliation, relationship, and suspension management with Health Care Providers.


You will be in charge of the communication of the outcome to the facilities, support them in interpreting the feedback received from Cigna and close follow up on the further actions needed.

You will work very closely with your peers and the rest of Provider Services Organization across the globe.

Your role includes:
Responsible to enable an effective and efficient collaboration with health providers through monitoring and analysing the results of the reconciliation of the accounts fulfilled by the Provider Reconciliation team and other Operational KPIs;
Comprehensive support on their interpretation and assurance of further follow up if needed.
Conduct regular root cause analysis and consolidated feedback of the data obtained out of the Reconciliation outcome or other sources, striving for continuous service delivery improvement through BAU collaboration with different teams;
Active communication and prompt follow up combined with regular meetings with your dedicated health care providers.
Participation in coordination sessions with Network and Operations teams seeking for better practices in order to prevent service deficiencies and assure 5 star experience to health care providers;
Being a person of contact for providers and stakeholders in regards of Operational issues / queries within the IHDS organization

Support the PR Team to determine short and middle term solutions for smooth reconciliation process with Providers by continuously analysing the intake of queries and complaints, as well as conducting reviews of the current processes for potential improvements.

Consolidated feedback to PR Team striving for continuous service delivery improvement through BAU collaboration with different teams.
Deliver on operational KPI's within the PR team in terms of production, quality, TAT, suspensions and provider NPS.

Your Profile

Internal Candidates: 2 years of Cigna experience, relevant experience in other functions/companies, and a strong performance track record.

External Candidates:

At least 2 years of experience in Operations, Data analysis, Marketing/Communications or Relationship Management, with operational and customer/provider-facing experience profile.

Proficient in English, additional language required (French is a must)
Strong analytical and problem-solving skills.
International mind-set able to work remotely with colleagues, partners and providers across the globe.
Striving for excellent service to our members, clients and providers is part of your DNA.
Detail oriented
Ability to engage in multiple tasks and meet deadlines.
Act with a sense of urgency to research questions or issues brought by different teams. Identify the right parties or resources to resolve these issues.

Ability to assess the situation/issue, carry out appropriate research, gather the relevant data and provide constructive feedback on the outcome.

Excellent communication skills – verbal, written and presentation.

Be a positive role model and have the ability to work independently and in conjunction with co-workers of all levels.

Strong practical knowledge of MS Office applications (Advanced Excel Skills preferred).

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