Senior Fraud Investigator
hace 2 semanas
Cigna is a global health insurance company that advocates for better health through every stage of life.
Job Summary:We are seeking a highly skilled Senior Fraud Investigator to join our Payment Integrity team in Americas. As a Senior Fraud Investigator, you will play a critical role in detecting and recovering fraudulent payments, creating solutions to prevent claims overpayment, and monitoring future spend.
Key Responsibilities:- Investigate potential instances of fraud, waste, or abuse (FWA) across Cigna's International Markets books of business for claims incurred in Americas.
- Ensure PI savings are tracked and reported accurately.
- Negotiate with providers contracted by Cigna or out-of-Network providers.
- Review existing cases for any FWA trends and patterns.
- Working knowledge of GIH claims processes and systems.
- Experience of fraud investigation strongly desired.
- Minimum of 2 years of health insurance or healthcare provider experience.
$80,000 - $110,000 per year, depending on location and experience.
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