Cigna | Quality Review and Audit Analyst | Hartford, CT | United States | BigDataKB.com | 2022/10/29

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Job Location: Hartford, CT

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

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 23 – 35 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna .

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?

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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.




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