Group Claims Specialist

Description:
Ensure team manages all claims according to our Quality Claims Philosophy and Superior Care Management aspirations.
- Pay all covered claims and fulfill our contractual and fiduciary duties.
- Treat our customers as we would want to be treated.
- Act with integrity, objectivity and a sense of urgency in the evaluation of claims.
- Assist our employer customers and their disabled employees in the shared goal of returning to work

Manage team?s claim performance according to published Quality and Compliance standards.

Establish and execute ongoing compliance plan for the team consistent with the Division?s Compliance standards.

Monitor and report on compliance issues.

Ensure communication/training of all new regulations.

Ensure Sarbanes Oxley compliant

Identify and implement opportunities to improve clinical outcomes including managing return to work results.

Utilize/Analyze metrics reports to ensure consistent team performance and identify areas of opportunity.

Effectively partner with resources and identify opportunities to strengthen resource management/utilization.

To support Network persistency goals, provide consistent service by responding to customer inquiries and delivering on service commitments

Demonstrate leadership through:
- Developing a high performing team
- Attracting, hiring, developing and retaining the best people
- Execute on coaching
Differentiating performance by rewarding high performers and managing low performers up.

Qualifications:
4+ years disability case management experience required or CMIII.
BA/BS or equivalent work experience required (Required).
Possesses strong communication and interpersonal skills.
Is committed to meeting and exceeding the expectations of internal and external customers.
Maintains exceptional customer relations while continuously identifying opportunities for improvement.
Exceptional analytical skills and ability to comprehend and clarify complex concepts.
Maintains professionalism and flexibility despite conflicting demands.
Ability to prioritize critical objectives focusing on high impact components.
Demonstrates a mastery of CIC Case Management and the functional and technical knowledge and skills to perform the job.
Ability to function efficiently with minimal supervision.
Ability to learn process and product information quickly and efficiently.
Ability to function effectively in a team environment while making individual contributions.

Salary/Benefits: Salary commensurate with experience
CIGNA offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development.

Job Location: Glendale, CA

Job Number: 42422

Company URL: http://www.CIGNA.com

Company Profile:
At CIGNA, we are committed to providing our customers with employee benefits, expertise and services that improve the health, well-being and productivity of their employees. CIGNA's people are the key to our success in a changing and increasingly competitive marketplace. The collective skills, behaviors and work experiences of all CIGNA employees enable us to make a real difference in the lives of our members. We seek the most talented and creative minds in the industry to develop innovative solutions our customers value and consumers expect.