Fraud Analyst - Cigna Healthcare
Core
Detect and recover fraudulent, waste, or abusive (FWA) payments in Cigna's international healthcare claims and implement solutions to prevent overpayment.
Role type
Senior IC fraud analyst (healthcare claims)
Builds
FWA prevention solutions and automated triggers
Domain
Healthcare insurance / Payment integrity
Deliverable
production ML models | dashboards & analysis
Required skills
Fraud investigation, healthcare claims experience, claims coding, regulatory rules, medical policy, data analytics, data mining, stakeholder partnership
Preferred skills
Medical/paramedical qualification, foreign language fluency, Microsoft suite
Responsibilities
Investigate potential FWA instances across international markets, seek recovery of FWA payments, track and report savings, perform data-mining to reveal FWA trends, partner with TPAs and Data Analytics teams, provide investigation reports
Seniority
Senior, hands-on IC
