APAC Quality Management PrePay Claim Audit

1 week ago

Kuala Lumpur, Kuala Lumpur, Malaysia The Cigna Group Full time
The job profile for this position is Quality Review and Audit Analyst, which is a Band 2 Senior Contributor Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

RESPONSIBILITIES

  • 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 procedures.
  • 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 Quality Management Supervisor.
  • Audits communications across EGS regions, primarily AP Claim.

EXPERIENCE REQUIRED

  • Ideally AP Claims experience of at least 2 years and familiar with Eurocare.
  • 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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.

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