GIH Claims Supervisor

PURPOSE/KEY OBJECTIVE:

The Claims Team Leader is responsible for managing a team of claims assessors and overseeing the accurate and timely processing of healthcare insurance claims. This role ensures operational efficiency compliance with regulatory standards and high levels of customer satisfaction through effective leadership and process oversight.

YOUR RESPONSIBILITIES

Your role will be to:

Team Leadership: Lead coach train and develop a team of claims assessors to achieve performance and quality targets.

Team Coordination: Allocate tasks monitor productivity and support team members with escalated issues.

Responsible for the management of the priority partner and task force escalation team members ensuring their tasks are managed to the established SLAs/KPIs and to a high standard.

Claims Management: Overseeing the processing of claims resolving issues and maintaining quality control.

Performance Management: Monitor team performance conduct regular feedback sessions performance reviews and provide constructive coaching to help individuals and the team reach their potential.

Customer Service: Addressing customer inquiries and complaints enhancing the overall claims experience.

Customer Experience & NPS Improvement: Champion initiatives that enhance customer experience and drive NPS improvement.

Reporting and Analysis: Assist in the preparation of management reports and tracking of performance metrics.

Collaboration: Work closely with other books of business and stakeholders to resolve claims efficiently.

Continuous improvement: Recommend and implement process enhancements to improve efficiency and customer satisfaction

Presentation: Prepare and present claims performance reports customer insights and improvement plans to senior leadership.

Scope and Dimensions:

Reporting directly to the GIH Senior Supervisor GIH Operations Team

YOUR PROFILE

Experience skill and knowledge required

• Proven ability to lead and motivate teams.
• In-depth knowledge of insurance claims procedures.
• Proven track record of delivering Net Promoter Score (NPS) improvements through operational and service enhancements.
• High level of accuracy in reviewing and processing claims
• Familiarity with claims management software and Microsoft Office tools especially MS Excel.
• Ability to communicate knowledge and develop skills to others.
• Ability to provide constructive feedback; work patiently and effectively with claims handlers of different experience levels learning styles and cultural diversity.
• Ability to work independently and make effective decisions; coordinate multiple tasks and work effectively as a team member.
• Ability to independently respond to inquiries complaints or appeals ranging from routine to moderate complexity.
• Demonstrate a customer-centric orientation with a key focus on process improvement and operational efficiency
• Exceptional organizational and time-management focus
• Strong verbal and written communication skills.
• Ability to prioritize tasks effectively and meet deadlines
• Analytical skills to address discrepancies and client issues effectively.
• Ability to interpret data and make informed decisions
• Ability to create and deliver impactful presentations to senior leadership including performance insights and strategic recommendations.

Preferred experience/education/professional qualifications:

• At least 5 years of experience in claims management or a related area within the insurance industry
• At least 3 years of experience in a supervisory or team leadership role.
• Diploma/Degree/Masters holder.
• English: C1 level written and spoken.

About The Cigna Group