Quality Review and Audit Representative

The job profile for this position is Quality Review and Audit Associate Analyst, which is a Band 2 Senior Contributor Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!

Our people make all the difference in our success.

As a Claims Payment Analyst you will be directly supporting Cigna’s affordability commitment within Cigna International's business.

Your responsibilities will include:

• Perform a variety of prepay focused cost avoidance activities including:
  • Audit and review accuracy of claim payments.
  • Identifying internal operational errors to prevent incorrect payment being made.
  • Verification of charges and services.
  • Participate in projects to improve business processes.
• Escalate suspicious activity to the Payment Integrity team.
• Identify drivers of errors and opportunities to reduce these.
• 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 controls to prevent further risk exposure.
• Help develop and distribute reports to key stakeholders.

Qualifications

• Demonstrated strong organization skills and attention to detail.
• Competent in processing or investigating claims.
• Data analysis and reporting skills preferred.
• 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.
• Strong written and verbal communication skills.
• Proficiency with Microsoft Excel needed. Word, PowerPoint, Outlook, and SharePoint preferred.
• Experience processing international claims preferred.

Competencies

• Learning and applying quickly.
• Organizing.
• Priority Setting.
• Problem Solving.
• Interpersonal Savvy.

Please note that you must meet our posting guidelines to be eligible for consideration.  Policy can be reviewed at this link.