Policy Validation Representative

Job Summary

Role Overview:

• Delivers straightforward administrative and/or other basic business services in Contracts.
• Issues tend to be routine in nature.
• Good knowledge and understanding of Contracts and business/operating processes and procedures.
• Reviews and analyzes implementation materials to create documents for new and existing business.
• Analyzes benefits to ensure they are in compliance with legislation. Loads benefits into system.
• Researches coordinates information and responds to questions from internal partners and/or external clients.
• May be the first point of contact from customer to resolve issues. Identifies process improvements for own cases.
• Negotiates deliverables with internal partners.
• May audit accounts to determine compliance with specific mandates.
• Works to clearly defined procedures under close supervision

Key Responsibilities:

• Working directly with clients (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.

• Fallouts: Working directly with clients to manage fallouts & arrange compliance information for successful CHI upload.

• Contracts: Building & implementing policy contracts when requested.

• Duplicate Insurance: Communicate with clients on the status of duplicate insurance & implement client decision with upload to CHI within 15 days.

• Policy Validation: Arranging required compliance documents & information to confirm policy validation.

• Wathq/Yakeen : Utilizing enablers like Wathq & Yakeen to independently validate policy details

• Misc.: Any related tasks on membership/policy assigned by Manager.

• Report: Prepare daily status report on new/renewal policies & fallouts

Qualifications:

• Bachelors or Masters degree in business or related Industry.

• Minimum of 23 years of experience in Membership/Enrolment or Sales support.
  

Skillset:

• Good communication and skills & medium skill level on MS office.

• Good knowledge on CHI/IA/SAMA/CMA regulations

• Fluent in English and Arabic.

Competencies:

Influencing : Working with all stakeholders/customers to arrange required data

Team player : Work cohesively with different functions to ensure target delivery

Accountability : Ability to hold self & others accountable for continuous improvement.

About The Cigna Group

Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group were 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: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.

Required Experience:

Unclear Seniority

Key Skills

• Data Entry
• Deputy
• Drafting
• Hibernate
• Administration Support
• Activex

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