Performs process compliance audits to determine the accuracy, compliance and consistency of all operational activities against the corresponding procedures. Operational activities include onboarding a client, setting up new and retained business on the system, claims processing, customer service (calls and emails) and the management of endorsement activities within the policies.
Responsibilities
Participates in complex audits, third party audits, ad-hoc projects and assignments as defined by the Quality Audit Team Manager.
Performs root cause analysis on audit findings to understand why the findings occurred.
Agrees suitable action plans to remove root causes and prevent findings from recurring.
Monitors performance trends and agrees suitable action plans to address these trends.
Identifies improvements to both audit and operational processes and procedures.
Collates and reports audit findings to Senior Management accurately and on time.
Assists in the development of audits and audit processes and procedures.
Acts as a subject matter expert who supports their fellow Auditors.
Experience & Competencies
2 years’ experience in Middle East Insurance Market
2 years’ experience in medical claims and/or an auditing role *for claims audit role
Excellent English skills, verbal and written – Arabic may be required for specific roles
Medical background preferred
High energy, results-oriented individual able to coordinate and prioritize multiple tasks in order to meet deadlines.
Ability to think analytically, interpret information / observations and make effective decisions.
Ability to ask for guidance, when required, on complex issues.
Professional verbal and written communication skills.
Ability to listen attentively, build rapport and ask structured open / closed questions.
Ability to diffuse and resolve instances of conflict.
Ability to produce clear and factual reports.
Ability to present information and ideas in a confident, creative and interactive manner.
Ability to explain audit findings and trends and provide constructive feedback; work patiently and effectively with staff of different experience levels, learning styles and cultural diversity.
Ability to provide constructive coaching to fellow Auditors in order to share knowledge and skills.
Ability to work effectively on their own and as part of a team.
Mindful of the needs of the business and the personal needs of the person being audited.
We are currently accepting applications from UAE Nationals only.
About Cigna Healthcare
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourselfEMEA@cigna.com for support. Do not email SeeYourselfEMEA@cigna.com for an update on your application or to provide your resume as you will not receive a response.