Inspector/a Hospitalario/a - Cigna Healthcare
Core
Hospital inspector and case management support for Cigna Healthcare, focusing on medical cost control, billing review, and patient experience optimization.
Role type
Senior IC healthcare operations specialist (hospital inspection & case management)
Builds
Cost-efficient procedures and billing processes for healthcare providers
Domain
Health insurance / Healthcare administration
Required skills
Nursing degree, 3+ years in insurance or hospital administration/billing, fraud detection, provider negotiation, electronic billing implementation
Preferred skills
High-level English, clinical hospital experience
Responsibilities
Control census and track hospital admissions, review and control hospital billing, improve Cigna patient experience, support call center for medical advice, refer patients to case management, control medical cost (hospitals and professionals), manage authorization/execution/billing circuit, detect fraud waste and abuse, design cost-efficient procedures, manage hospital beds, negotiate provider tariffs and billing differences, implement electronic billing for providers, design and negotiate provider fee schedules