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Quality Review and Audit Analyst, Madrid

Created11/20/2020
Reference20020532
CategoryOperations
Job typeFull Time
CountrySpain
CityMadrid
Zip28001
SalaryCompetitive
YOUR JOB
  • You review and analyze triggered cases based on pre- and post-payment risk assessments and take appropriate action.
  • You assist in examining files that are passed on to the FWA team for suspected fraud, waste or abuse.
  • Where needed, you support the team of investigators or provider financial oversight team in gathering facts on suspected cases.
  • You give advice for claims release and track steps taken accordingly.
  • You assist in reaching out to suspected providers and may conduct fact-finding interviews.
  • You help reveal patterns of fraud, waste or abuse in your designated region through data-mining exercises.
  • Based on your initial analysis, you are able to summarize your findings in a summary report, to be directed to the region's designated investigations team.
  • You follow-up with stakeholders to ensure deadlines are met and any delays are communicated proactively.
  • You manage your workload proactively, communicating with your manager any risks or challenges to targeted completion dates.
  • You are able to identify new opportunities and take an active role in optimizing workflows of the department.
  • You take initiative and show confidence in your correspondence with internal and external parties.


YOUR PROFILE
  • You have a bachelor degree or equivalent through experience. Any prior experience in the field is preferred.
  • You have an excellent knowledge of English. Any additional foreign languages, espeically Arabic or Russian would be a plus.
  • Good medical knowledge or a strong interest in exploring the medical field is preferred.
  • You have a strong knowledge of Microsoft Office, especially Excel.
  • You are analytical and have a critical mindset.
  • You are decisive and able to work independently as well as within a team.
  • You have a positive stance and influence within the team.
  • You act with the highest integrity and respect for procedures and regulations.
  • You work efficiently and accurately.
  • You are excellent in setting priorities.


About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, 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 Cigna, you'll enjoy meaningful career experiences that enrich people's lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.

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: SeeYourselfEMEA@cigna.com for support. Do not email SeeYourselfEMEA@cigna.com for an update on your application or to provide your resume as you will not receive a response.
EmployerES3 ESP Cigna European Services

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