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Prepay Claims Auditor

2 months ago

Kuala Lumpur, Kuala Lumpur, Malaysia The Cigna Group Full time

Quality Management Auditor

Your Role

  • Conduct thorough audits of Prepay claims to ensure accuracy, consistency, and compliance with established procedures.
  • Proactively identify potential issues and risks, and provide recommendations for improvement.
  • Participate in focus audits, projects, and third-party audits to enhance audit processes and procedures.
  • Perform root cause analysis on audit findings to understand the underlying causes and communicate results to Operations.
  • Identify opportunities for process improvements and contribute to the development of new audit processes and procedures.
  • Support auditors in other audit lines with language expertise and provide cross-functional support as needed.

Scope and Responsibilities

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

Requirements

  • At least 2 years of experience in AP Claims, with familiarity with Eurocare.
  • Experience in audit, training, review, or coaching is highly beneficial.

Your Profile

  • A high-energy, results-driven individual with excellent coordination and prioritization skills.
  • Ability to think analytically, interpret information, and make effective decisions.
  • Proficient written and verbal communication skills, with a strong command of English.
  • Ability to listen actively, build rapport, and ask structured questions.
  • Confident presentation skills, with the ability to explain complex information in a clear and concise manner.
  • Ability to work effectively independently and as part of a team.
  • Mindful of the needs of the business, clients, and individuals being audited.

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is a leading health services company dedicated to improving lives through better health. We empower our customers with the information and insight they need to make informed decisions about their health and well-being. Join us in driving growth and improving lives.