Fraud Analyst

hace 4 semanas

Madrid, Madrid, España The Cigna Group A tiempo completo

Job Description

Fraud Analyst (Pre-Pay)

The job profile for this position is Fraud Audit Analyst (Pre-Pay), which is a Band 2 Senior Contributor Career Track Role.

Role Summary:

As a Fraud Analyst (Pre-Pay), within the Payment Integrity Department you will be directly supporting Cigna's affordability commitment within Cigna International's business. This role is responsible for identifying and preventing fraudulent, wasteful and abusive expenses from around the globe and supporting the Payment Integrity FWA Team with client reporting.

Responsibilities:

  • Manages Team mailbox and responds or directs enquiries appropriately.
  • Acts as initial review point for (possible) fraudulent claims.
  • Identifying claims with potential waste and abuse
  • Provides initial review and research to help determine if claims require further investigation to determine possible fraudulent activity.
  • Contact providers requesting documents and confirming information.
  • Uphold documentation and process standards
  • Partner with cost containment teams in other geographies to share best practices.
  • Participate in projects to improve business processes.
  • Ensure team savings are tracked and reported accurately.
  • Partner with Payment Integrity teams in other locations to share FWA claiming schemes.
  • Partner with Data Analytics team in building future FWA triggers automation.
  • Support the production of investigation reports to internal and external stakeholders by compiling and storing evidence appropriately.

Skills and Requirements:

  • You should enjoy working in a team of high performers, who hold each other accountable to perform to their very best.
  • Experience of fraud investigation strongly desired.
  • Minimum of 2 years of health insurance or health care provider experience.
  • Competent in processing or investigating claims on GlobalCare.
  • Knowledge of claims coding, regulatory rules and medical policy.
  • Medical/ paramedical qualification is a definite plus.
  • Demonstrated strong organization skills.
  • Strong attention to detail.
  • Ability to quickly learn new and complex tasks and concepts.
  • Critical mind-set with ability to identify cost containment opportunities.
  • Excellent verbal and written communication skills.
  • Ability to balance multiple priorities at once and deliver on tight timelines.
  • Flexibility to work with global teams and varying time zones effectively.
  • Confidence to deal with internal stakeholders and ability to work with a cross functional team.
  • Strong organization skills with the ability to juggle priorities and work under pressure to meet tight deadlines.
  • Fluency in foreign languages in addition to fluent English is a strong plus.

About Cigna Healthcare

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.

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: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.


  • Fraud Analyst

    hace 3 semanas

    Madrid, Madrid, España The Cigna Group A tiempo completo

    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...

  • Fraud and Risk Management Specialist

    hace 2 días

    Madrid, Madrid, España Rank Group A tiempo completo

    **About Us**Rank Group is a leading online gaming operator in the Spanish markets, with a strong presence in the online and offline sectors. Our portfolio includes bingo, casino, and sports betting, with a focus on providing entertainment to our customers through our websites and apps.**Our Goal**We strive to provide a secure and enjoyable experience for our...

  • Fraud and Risk Management Specialist

    hace 2 días

    Madrid, Madrid, España Rank Group A tiempo completo

    **About Us**Rank Group is a leading online gaming operator in the Spanish markets, with a strong presence in the online and offline sectors. Our portfolio includes bingo, casino, and sports betting, with a focus on providing entertainment to our customers through our websites and apps.**Our Goal**We strive to provide a secure and enjoyable experience for our...

  • Fraud Analyst Internship

    hace 2 días

    Madrid, Madrid, España Spotahome A tiempo completo

    About SpotahomeSpotahome is a leading online marketplace that offers verified rental accommodation across 100 European cities in 27 countries. Our mission is to revolutionize the traditional real estate space by digitalizing rentals and making it easy for people to book properties online.Our ApproachWe take a proactive approach to ensuring the accuracy and...

  • Fraud Analyst Internship

    hace 2 días

    Madrid, Madrid, España Spotahome A tiempo completo

    About SpotahomeSpotahome is a leading online marketplace that offers verified rental accommodation across 100 European cities in 27 countries. Our mission is to revolutionize the traditional real estate space by digitalizing rentals and making it easy for people to book properties online.Our ApproachWe take a proactive approach to ensuring the accuracy and...

  • Fraud Prevention Analyst

    hace 4 semanas

    Madrid, Madrid, España American Express A tiempo completo

    Empowerment Through Support. At American Express, we believe that with the right support, individuals and organizations can achieve remarkable progress. As part of our diverse and global team, you will be immersed in a culture that prioritizes the well-being of our customers, communities, and each other. Here, you will have the opportunity to develop a...

  • Fraud Prevention Analyst

    hace 4 días

    Madrid, Madrid, España American Express A tiempo completo

    Empowerment Through Support. At American Express, we believe that with the right support, individuals and organizations can achieve remarkable progress. As part of our diverse and global team, you will be immersed in a culture that prioritizes the well-being of our customers, communities, and each other. Here, you will have the opportunity to develop a...

  • Fraud Prevention Analyst

    hace 4 semanas

    Madrid, Madrid, España Spotahome A tiempo completo

    About Spotahome Spotahome is a global online platform that provides verified rental accommodations across 100 cities in 27 countries, with a vision to transform the traditional real estate market by digitizing the rental process. Founded in 2014 by four friends, we aim to simplify renting by enabling users to book properties online from anywhere in the...

  • Fraud Prevention Analyst

    hace 4 días

    Madrid, Madrid, España Spotahome A tiempo completo

    About Spotahome Spotahome is a global online platform that provides verified rental accommodations across 100 cities in 27 countries, with a vision to transform the traditional real estate market by digitizing the rental process. Founded in 2014 by four friends, we aim to simplify renting by enabling users to book properties online from anywhere in the...

  • Corporate Intelligence Analyst

    hace 2 meses

    Madrid, Madrid, España KPMG A tiempo completo

    ¿Qué podrás hacer? Nuestra práctica de Forensic Services es líder a nivel nacional y ofrece servicios de prevención e investigación de fraudes y de asistencia como expertos independientes en conflictos judiciales y extrajudiciales. Nuestro objetivo es ofrecer a nuestros clientes servicios multidisciplinares en situaciones de fraude o conflicto,...

  • Senior Product Definition Analyst

    hace 4 días

    Madrid, Madrid, España Amadeus A tiempo completo

    About the RoleWe are seeking a highly skilled Senior Product Definition Analyst to join our team at Amadeus. As a key member of our product development team, you will be responsible for designing and enhancing pivotal payment functionalities, including 3DS, Fraud screening, and Tokenization.Key ResponsibilitiesAnalyse business requirements to craft optimal...

  • Senior Product Definition Analyst

    hace 3 días

    Madrid, Madrid, España Amadeus A tiempo completo

    About the RoleWe are seeking a highly skilled Senior Product Definition Analyst to join our team at Amadeus. As a key member of our product development team, you will be responsible for designing and enhancing pivotal payment functionalities, including 3DS, Fraud screening, and Tokenization.Key ResponsibilitiesAnalyse business requirements to craft optimal...

  • Corporate Credit Risk Analyst

    hace 4 días

    Madrid, Madrid, España Us Bank A tiempo completo

    About the Role:As a Corporate Credit Risk Analyst at U.S. Bank, you will play a critical role in helping our customers and businesses make informed financial decisions. You will be responsible for conducting thorough credit analyses, gathering and interpreting credit information, and preparing credit reports for decision-makers.Key Responsibilities:Analyze...

  • Corporate Credit Risk Analyst

    hace 5 días

    Madrid, Madrid, España Us Bank A tiempo completo

    About the Role:As a Corporate Credit Risk Analyst at U.S. Bank, you will play a critical role in helping our customers and businesses make informed financial decisions. You will be responsible for conducting thorough credit analyses, gathering and interpreting credit information, and preparing credit reports for decision-makers.Key Responsibilities:Analyze...

  • Corporate Credit Risk Analyst

    hace 4 días

    Madrid Centro, Madrid, España Us Bank A tiempo completo

    Job SummaryWe are seeking a highly skilled Corporate Credit Risk Analyst to join our team at U.S. Bank. As a key member of our credit analysis team, you will be responsible for conducting thorough credit analyses, gathering and interpreting credit information, and making informed credit decisions.Key ResponsibilitiesConduct Credit Analyses: Gather, analyze,...

  • Corporate Credit Risk Analyst

    hace 4 días

    Madrid Centro, Madrid, España U.S. Bank A tiempo completo

    Job SummaryWe are seeking a skilled Corporate Credit Risk Analyst to join our team at U.S. Bank. As a key member of our credit underwriting team, you will be responsible for conducting thorough credit analyses, gathering and interpreting credit information, and making informed credit decisions.Key ResponsibilitiesConduct credit analyses, including gathering...

  • Corporate Credit Risk Analyst

    hace 5 días

    Madrid Centro, Madrid, España U.S. Bank A tiempo completo

    Job SummaryWe are seeking a skilled Corporate Credit Risk Analyst to join our team at U.S. Bank. As a key member of our credit underwriting team, you will be responsible for conducting thorough credit analyses, gathering and interpreting credit information, and making informed credit decisions.Key ResponsibilitiesConduct credit analyses, including gathering...

  • Corporate Credit Risk Analyst

    hace 3 días

    Madrid Centro, Madrid, España Us Bank A tiempo completo

    Job SummaryWe are seeking a highly skilled Corporate Credit Risk Analyst to join our team at U.S. Bank. As a key member of our credit analysis team, you will be responsible for conducting thorough credit analyses, gathering and interpreting credit information, and making informed credit decisions.Key ResponsibilitiesConduct Credit Analyses: Gather, analyze,...

  • Onboarding Risk Analyst

    hace 17 horas

    Madrid, Madrid, España Ebury A tiempo completo

    About the RoleEbury is a leading financial services company that prides itself on its high standards when working with clients. As an Onboarding Risk Analyst, you will play a vital role in ensuring that our clients and transactions adhere to all legal, regulatory, and ethical standards.Key ResponsibilitiesSafeguard Ebury, our existing clients, and...

  • Corporate Credit Risk Analyst

    hace 4 días

    Madrid, Madrid, España Us Bank A tiempo completo

    About the Role:As a Corporate Credit Risk Analyst at U.S. Bank, you will play a critical role in helping our customers and businesses make informed financial decisions. You will be responsible for conducting thorough credit analyses, gathering and interpreting credit information, and preparing credit reports for decision-makers.Key Responsibilities:Analyze...