Quality Review and Audit Representative

As a Claims Payment Analyst you will be directly supporting Cigna s affordability commitment within Cigna Internationals 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.

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.