Job Description

Quality Management

Auditor

YOUR JOB

• Perform audits on Prepay claims to determine accuracy, consistency, and compliance regarding established procedures.
• Proactively flag possible issues and risks.
• You may participate in focus audits, projects and third-party.
• You may perform root cause analysis on audit findings to understand why the findings occurred and communicate those in the monthly meetings with Operations.
• Identifies improvements to both audit and operational processes and p rocedures.
• Assists in the development of audits and audit processes and procedures.
• Support auditors in other audit lines with specific language knowledge and cross support when required.

SCOPE AND DIMENSIONS

• Reports directly to the Claims Supervisor.
• Audits communications across EGS regions, primarily AP Claim.

EXPERIENCE REQUIRED

• Ideally AP Claims experience of at least 2 years.
• Experience in audit, training, review, or coaching would be beneficial.

YOUR PROFILE

• High energy, results-oriented individual able to coordinate and prioritize multiple tasks to meet deadlines.
• Ability to think analytically, interpret information / observations and make effective decisions.
• Ability to ask for guidance, when required, on complex issues.
• Professional verbal and written communication skills.
• You have proficient knowledge of at least English.
• Ability to listen attentively, build rapport, and ask structured open / closed questions.
• Ability to present information and ideas in a confident, creative and interactive manner.
• Ability to explain audit findings and trends and provide constructive feedback; work patiently and effectively with staff of different experience levels, learning styles and cultural diversity.
• Ability to provide constructive coaching to fellow Auditors to share knowledge and skills.
• Ability to work effectively on their own and as part of a team.
• Mindful of the needs of the business, the clients and the personal needs of the person being audited.

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.