More than 100,000 people have found their dream job through Fuzu.

CLOSED FOR APPLICATIONS

Quality Review And Audit Analyst

Closing: Sep 22, 2022

This position has expired

Published: Sep 15, 2022 (11 days ago)

Job Requirements

Education:

Work experience:

Language skills:

Job Summary

Contract Type:

Sign up to view job details.

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


Responsibilities

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


  • 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


Applications submitted via Fuzu have 32% higher chance of getting shortlisted.

Don’t miss your chance to work at Cigna. Enter your email to start your application now