Quality Review & Audit Analyst | Cigna Gulf Careers
Position: Quality Review & Audit Analyst –Payment Integrity
This role is responsible for detecting and recovering FWA payments, creating solutions to prevent claims overpayment and future spend monitoring within a dedicated region.
- Investigate potential instances of fraud, waste or abuse (FWA) across all Cigna’s International Markets books of business (excluding IO) for claims incurred in a dedicated region.
- Seek recovery of FWA payments from claim submissions.
- Ensure PI savings are tracked and reported accurately.
- Perform data-mining to reveal FWA trends and patterns.
- Collaborate with the Special Investigation Unit on Fraud cases.
- Minimum of 2 years of health insurance or health care provider experience.
- Knowledge of Globalcare, Actisure and/or Diamond essential.
- Knowledge of claims coding, regulatory rules and medical policy.
- Medical/ paramedical qualification is a definite plus.
- Experience with data analytics
|Title||Quality Review & Audit Analyst | Cigna Gulf Careers|
|Job Location||Dubai, UAE|
|Employment Type||Full Time|
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* This Job was originally posted on Cigna site…