Cigna Quality Review and Audit Analyst Jobs in Kenya

Cigna Quality Review and Audit Analyst Jobs in Kenya

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.

Responsibilities

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

Deadline: 16th October 2022

How to Apply

For more information and job application details, see: ( Cigna Quality Review and Audit Analyst Jobs in Kenya)

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