Cigna Jobs

Quality Review and Audit Analyst

As a Quality Review & Audit Analyst working on the Payment Integrity Team you will be directly supporting Cigna’s affordability commitment within Cigna International's business.

Your responsibilities will include:

• Identifying and preventing fraudulent, wasteful and abusive expenses from around the globe

• Perform a variety of prepay focused cost avoidance activities including:

• Identifying suspicious activity and submission to the designated FWA and SIU team for investigation

• Identifying internal operational errors to prevent incorrect payment being made

• Electronic outreaches to providers requesting documents and confirming information

• Occasional telephonic outreach to providers in local region to negotiate savings

• Verification of charges and services

• Negotiation on high cost provider claims

• Partner with cost containment teams in other geographies to share best practices

• Analyze data on prior payments to identify additional opportunities

• Participate in projects to improve business processes

• Working collaboratively in a team environment to efficiently utilize each individual’s strengths

• Working closely with other departments to ensure our activities do not have an unnecessary negative impact on our customers

• Providing feedback to other departments in order to put in place safeguards to prevent further risk exposure

Qualifications

• Demonstrated strong organization skills

• Strong attention to detail

• Ability to quickly learn new and complex tasks and concepts

• Competent in processing or investigating claims on either the Mainframe or Diamond claim platforms

• Fluency in foreign languages in addition to fluent English is a strong plus

• Data analysis and reporting skills preferred

• Inquisitive nature capable of thinking critically and challenging assumptions

• Demonstrated follow through on complex problems and tasks

• Comfortable working independently and with a team

• Ability to balance multiple priorities at once and deliver on tight timelines

• Ability to stay up to date on operations workflows

• Ability to develop and effectively communicate presentations and training materials

• Strong written and verbal communication skills

• Patience and creativity amongst your strong points

• Proficiency with Microsoft Excel needed. Word, PowerPoint, Outlook, and SharePoint preferred

• Experience processing international claims preferred

• Comfort with telephonic outreaches to global entities preferred

Competencies

• Learning and applying quickly

• Organizing

• Priority Setting

• Problem Solving

• Interpersonal Savvy

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?