Account Installation Representative
Job Fit Check
Base Career helps you apply smarter for this job.
Key skills for this role
About the Role
About the role: The Account Installation Representative is responsible for accurately configuring and maintaining medical benefit plans within internal and TPA systems. This ro.
Key Skills for This Role
Responsibilities
- Analyze product documents and policy schedules to build and configure benefit plans for both internal use and TPA.
- Set up eligibility, copays, deductibles, out of pocket maximums, covered services, and provider networks, annual/lifetime caps and service level exclusions/inclusion.
- Maintain and validate API/data feed integration between internal system and TPA systems (e.g., policy enrollment, benefit tables, provider networks).
- Review and validate group setup and benefit plan changes, updates, and renewals.
- Coordinate with underwriting, sales, and client services teams to gather accurate plan information.
- Validate benefit configurations before policy activation to avoid claim errors.
- Work closely with underwriting, sales, Business support, and policy validation teams to ensure accurate reflection of client and product specifications.
- Participate in UAT (User Acceptance Testing) for plan benefit setups or system enhancements.
- Coordinate with TPAs to align benefit configuration between internal system and the TPA platforms.
- Conduct benefit mapping and data exchange configuration manuals and documents with TPAs.
- Maintain configuration documentation, setup logs, and audit trails as per regulator and internal compliance protocols.
- Responsible for partnering with broader Operations teams to ensure activities related to Operational Readiness, including business support, eligibility, compliance contact center and claims are ready to service by client's effective date.
Requirements
- Analyze product documents and policy schedules to build and configure benefit plans for both internal use and TPA
- Set up eligibility, copays, deductibles, out of pocket maximums, covered services, and provider networks, annual/lifetime caps and service level exclusions/inclusion
- Maintain and validate API/data feed integration between internal system and TPA systems (e.g., policy enrollment, benefit tables, provider networks)
- Review and validate group setup and benefit plan changes, updates, and renewals
- Coordinate with underwriting, sales, and client services teams to gather accurate plan information
- Validate benefit configurations before policy activation to avoid claim errors
- Work closely with underwriting, sales, Business support, and policy validation teams to ensure accurate reflection of client and product specifications
- Participate in UAT (User Acceptance Testing) for plan benefit setups or system enhancements
- Coordinate with TPAs to align benefit configuration between internal system and the TPA platforms
- Conduct benefit mapping and data exchange configuration manuals and documents with TPAs
- Maintain configuration documentation, setup logs, and audit trails as per regulator and internal compliance protocols
- Responsible for partnering with broader Operations teams to ensure activities related to Operational Readiness, including business support, eligibility, compliance contact center and claims are ready to service by client's effective date
Full Job Posting
About the role
- The Account Installation Representative is responsible for accurately configuring and maintaining medical benefit plans within internal and TPA systems.
- This role ensures that members, providers, and clients have correct and up to date information on eligibility, coverage rules, authorization requirements, and claim adjudication parameters.
Key Responsibilities
- Analyze product documents and policy schedules to build and configure benefit plans for both internal use and TPA.
- Set up eligibility, copays, deductibles, out of pocket maximums, covered services, and provider networks, annual/lifetime caps and service level exclusions/inclusion.
- Maintain and validate API/data feed integration between internal system and TPA systems (e.g., policy enrollment, benefit tables, provider networks).
- Review and validate group setup and benefit plan changes, updates, and renewals.
- Coordinate with underwriting, sales, and client services teams to gather accurate plan information.
- Validate benefit configurations before policy activation to avoid claim errors.
- Work closely with underwriting, sales, Business support, and policy validation teams to ensure accurate reflection of client and product specifications.
- Participate in UAT (User Acceptance Testing) for plan benefit setups or system enhancements.
- Coordinate with TPAs to align benefit configuration between internal system and the TPA platforms.
- Conduct benefit mapping and data exchange configuration manuals and documents with TPAs.
- Maintain configuration documentation, setup logs, and audit trails as per regulator and internal compliance protocols.
- Responsible for partnering with broader Operations teams to ensure activities related to Operational Readiness, including business support, eligibility, compliance contact center and claims are ready to service by client's effective date.
Apply for this job in 1 click
Skip the repetitive application forms
Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.
Trusted by over 500,000 job seekers on Base Career
More from this employer
More jobs at Cigna
Graphic Design Specialist
Dubai, UAE
The role involves developing visual assets, managing sales collateral, creating social media content, and ensuring brand consistency across marketing channels.
Actuarial Senior Analyst
United Arab Emirates, UAE
The candidate will analyze data, support actuarial investigations, and collaborate with various teams in the health insurance sector, requiring strong analytical skills.
Associate Talent Acquisition Business Partner
United Arab Emirates, UAE
As part of our Talent Acquisition team, you will help attract and hire talent across a variety of functions within GIH. You will partner with hiring managers, HR colleagues, and...
Talent Acquisition Business Partner
Riyadh, KSA
You will support recruitment primarily in Riyadh, while also partnering on vacancies in Kenya and other international markets. You will work in a fast paced, evolving environmen...
Business Development Manager
Dubai, UAE
Cigna Healthcare is hiring a Senior Business Development Manager for SME Sales to drive growth and improve lives. The role involves guiding customers through the healthcare system and empowering them with information. Qu
Account Management (IC) Associate
Riyadh, KSA
Be responsible for the assigned client as the designated delegate and support other corporate clients whenever required in their daily inquiries. Own and manage a book of client...
Broker Relationship Analyst
Riyadh, KSA
About the role : The Broker Relationship Analyst will be responsible for providing Broker and client support in the areas of service, maintenance and penetration. Respond to inq...
Actuarial Analyst
Saudi Arabia, KSA
Key Responsibilities Data analytics, reconciliations, and processing. Actuarial pricing for the Middle East and Africa region, including experience studies, setting book rates a...
Graphic Design Specialist
Dubai, UAE
Actuarial Senior Analyst
United Arab Emirates, UAE
Associate Talent Acquisition Business Partner
United Arab Emirates, UAE
Talent Acquisition Business Partner
Riyadh, KSA
Business Development Manager
Dubai, UAE
Account Management (IC) Associate
Riyadh, KSA
Broker Relationship Analyst
Riyadh, KSA
Actuarial Analyst
Saudi Arabia, KSA