Payment Integrity Quality Review and Audit Specialist
hace 1 semana
Quality Review and Audit Expertise
Cigna International's Payment Integrity Team seeks a skilled Quality Review and Audit Expert to support the company's affordability commitment. As a key member of this team, you will directly contribute to ensuring the accuracy and integrity of payment processes worldwide.
Key Responsibilities:
• Identify and prevent fraudulent, wasteful, and abusive expenses globally
• Collaborate with the Payment Integrity Team to implement prepay focused cost avoidance activities, including:• Investigating suspicious activity and submitting findings to the designated FWA and SIU team
• Identifying internal operational errors to prevent incorrect payments
• Conducting electronic outreaches to providers for document verification and information confirmation
• Participating in telephonic outreaches to providers in local regions for negotiations and savings verification
• Partner with other areas within Payment Integrity to share best practices and improve business processes
• Work collaboratively with teams to efficiently utilize individual strengths and expertise
• Engage with other departments to ensure activities do not negatively impact customers
• Provide feedback to departments to implement safeguards and prevent risk exposure
Qualifications:
• Demonstrated strong organizational skills and attention to detail
• Ability to quickly learn complex tasks and concepts
• Proficiency in processing or investigating claims on Mainframe, Diamond, or GlobalCare claim platforms
• Fluency in foreign languages, in addition to fluent English, is a strong asset
• Data analysis and reporting skills are preferred
• Inquisitive nature with the ability to think critically and challenge assumptions
• Demonstrated follow-through on complex problems and tasks
• Ability to balance multiple priorities and deliver on tight timelines
• Proficiency with Microsoft Excel and preferred proficiency in Word, PowerPoint, Outlook, and SharePoint
Competencies:
• Learning and applying quickly
• Organizing and prioritizing tasks
• Problem-solving and analytical skills
• Interpersonal savvy and collaboration skills
-
Madrid, Madrid, España The Cigna Group A tiempo completoQuality Review and Audit Associate RoleCigna International's Payment Integrity Team is seeking a Quality Review and Audit Associate to support our affordability commitment. As a key member of the team, you will play a crucial role in identifying and preventing fraudulent, wasteful, and abusive expenses from around the globe.Key Responsibilities:Identify and...
-
Madrid, Madrid, España The Cigna Group A tiempo completoAbout the RoleWe are seeking a highly skilled Payment Integrity Quality Review and Audit Associate Analyst to join our team. As a key member of the Payment Integrity Team, you will play a critical role in supporting Cigna's affordability commitment within Cigna International's business.Key Responsibilities• Identify and prevent fraudulent, wasteful, and...
-
Fraudulent Expense Prevention and Recovery Specialist
hace 4 semanas
Madrid, Madrid, España The Cigna Group A tiempo completoPayment Integrity Quality Review and Audit SpecialistCigna International's Payment Integrity Team is seeking a skilled Quality Review & Audit Associate Analyst to directly support the company's affordability commitment. This crucial role involves identifying and preventing fraudulent, wasteful, and abusive expenses from around the globe.The ideal candidate...
-
Expert Payment Specialist
hace 1 semana
Madrid, Madrid, España Ing A tiempo completoJob Title: Expert Payment SpecialistIng is seeking a highly skilled Payouts Professional to join our team. As an Expert Payment Specialist, you will be responsible for ensuring the accuracy, timeliness, and reliability of payment transactions.About the RoleYou will have a deep understanding of payment regulations and compliance requirements relevant to...
-
Claims Quality Review Specialist
hace 1 mes
Madrid, Madrid, España Berkshire Hathaway Spec Ins A tiempo completoBerkshire Hathaway Specialty Insurance (BHSI) is a trusted insurance partner that provides a broad range of commercial property, casualty, and specialty insurance coverages to customers and brokers worldwide. We are a values-based organization that fosters an inclusive environment where respect, integrity, excellence, collaboration, and passion define who we...
-
Slovakian Content Review Specialist
hace 1 mes
Madrid, Madrid, España Wibit Consulting & Services (Wibitcs) A tiempo completoJob Title: Slovakian Content Review SpecialistAt Wibit Consulting & Services (Wibitcs), we are seeking a highly skilled Slovakian Content Review Specialist to join our team. As a Content Review Specialist, you will play a critical role in ensuring the quality and integrity of digital content. Key Responsibilities:- Review and score digital content for...
-
Claims Quality Review Specialist
hace 4 semanas
Madrid, Madrid, España Berkshire Hathaway Spec Ins A tiempo completoBerkshire Hathaway Specialty Insurance (BHSI) is a strategic and trusted insurance partner. We provide a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world.We are a values-based organization where respect, integrity, excellence, collaboration, and passion define who...
-
Senior External Vendor Audit Specialist
hace 1 semana
Madrid, Madrid, España Deutsche Bank A tiempo completoJob SummaryAs a Senior External Vendor Audit Specialist at Deutsche Bank, you will play a critical role in ensuring the adequacy and effectiveness of the diverse vendor control environments to meet key control requirements of the Bank. The Vendor Coverage team undertakes professional audit work in accordance with the Group Audit's methodology, providing...
-
Claims Quality Review Specialist
hace 1 mes
Madrid, Madrid, España Berkshire Hathaway Specialty Insurance A tiempo completoA trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), offers a range of commercial property, casualty and specialty insurance coverages and exceptional service to customers and brokers worldwide. As a values-based organization, we prioritize respect, integrity, excellence, collaboration, and passion in our work. We value diversity and...
-
Payment Cybersecurity Specialist
hace 1 semana
Madrid, Madrid, España Amadeus It Group A tiempo completoJob Title:Payment Cybersecurity SpecialistAbout the Role:We are seeking a highly skilled Payment Cybersecurity Specialist to join our Risk and Compliance team at Amadeus. As a key member of our cybersecurity initiatives, you will play a pivotal role in safeguarding the integrity of our payment ecosystem.Key Responsibilities:Develop and manage a robust...
-
Claims Quality Review Specialist
hace 4 semanas
Madrid, Madrid, España Berkshire Hathaway Specialty Insurance A tiempo completoJob Opportunity:Berkshire Hathaway Specialty Insurance is seeking a Claims Quality Review Specialist to join the Global Claims Quality Assurance team.This role offers opportunities for career growth and development in a dynamic and action-oriented environment.Duties & Responsibilities:The Claims Quality Review Specialist will be responsible for reviewing and...
-
Quality Assurance Specialist
hace 1 mes
Madrid, Madrid, España Sqa Services A tiempo completoJob Title: Quality Assurance SpecialistJob Summary:SQA Services is seeking a Quality Assurance Specialist to join our team. As a Quality Assurance Specialist, you will be responsible for performing quality audits at suppliers to our clients in the pharmaceutical, medical device, cosmetics, biologics, and/or animal health industries.Responsibilities:Perform...
-
Senior Payment Process Specialist
hace 1 semana
Madrid, Madrid, España Ing A tiempo completoKey Responsibilities:As a Payments Expert at ING, your role will be multifaceted, requiring expertise in compliance, risk management, processing efficiency, customer service, collaboration, and continuous improvement.**Deep Understanding of Payment Regulations**: Stay up to date on changes in regulations and ensure that payment processes adhere to legal and...
-
Senior Audit Specialist
hace 1 mes
Madrid, Madrid, España Empresa Reconocida A tiempo completoJob SummaryEmpresa Reconocida is seeking a highly skilled Senior Audit Specialist to join our team. As a key member of our audit team, you will be responsible for leading and participating in audits of Human Resources and Global Real Estate areas. Your expertise will be essential in evaluating the adequacy and effectiveness of internal controls relating to...
-
Senior External Vendor Audit Specialist
hace 7 días
Madrid, Madrid, España Deutsche Bank A tiempo completoAbout Us\Deutsche Bank, a global leader in financial services, has been driving innovation and progress for over 150 years.\\\We have a unique opportunity for a skilled Senior External Vendor Audit Specialist to join our team in Madrid, Spain.\\\Job Summary\The Senior External Vendor Audit Specialist will play a key role in supporting the evaluation of...
-
Research Integrity Auditor Specialist
hace 1 mes
Madrid, Madrid, España Frontiers A tiempo completoAbout the Role:We are seeking a highly skilled Research Integrity Auditor Specialist to join our team at Frontiers. As a Research Integrity Auditor Specialist, you will be the first point of contact for support and investigation in urgent, escalated cases across all journal portfolios.You will report to the Research Integrity Auditing Manager and be...
-
Product Owner
hace 1 mes
Madrid, Madrid, España Cigna A tiempo completoJob Summary:The Payment Integrity Project Senior Analyst role is a Band 3 Senior Contributor Career Track position within the International Markets business. As a key member of the Payment Integrity team, you will be responsible for supporting the maintenance of the Health Cloud environment and other relevant projects.Key Responsibilities:Manage the intake...
-
Senior Quality Assurance Specialist
hace 1 mes
Madrid, Madrid, España Alk-Abelló, AS A tiempo completoSenior QA SpecialistJoin Alk-Abelló, A/S in a challenging role as Senior QA Specialist. As a key member of our Quality Assurance team, you will be responsible for ensuring the quality of our products and processes.Key ResponsibilitiesPerform quality assurance activities associated with maintaining internal quality systems, including change control,...
-
Product Owner
hace 1 mes
Madrid, Madrid, España Cigna A tiempo completoJob SummaryThe Payment Integrity Project Senior Analyst role is a key position within the Payment Integrity team, responsible for supporting the maintenance of the Health Cloud environment and other relevant projects within the International Markets business.This role requires a strong analytical mindset, excellent communication skills, and the ability to...
-
Internal Audit Specialist
hace 1 mes
Madrid, Madrid, España Devoteam A tiempo completoInternal Audit Role:As an Internal Audit Specialist at Devoteam, you will be responsible for preparing the annual audit plan and presenting it to the audit committee. Your tasks will include participating in meetings with local management to discuss last year's findings and current year situation, performing sample testing to detect potential...