Fraud Analyst -Payment Integrity Member Investigation Unit The job profile for this position is Fraud Analyst -Payment Integrity Member Investigation Unit MIU 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 right for you we encourage you to apply Our people make all the difference in our success Role Summary As Fraud Analyst within the Member Investigation Unit MIU you will be directly supporting Cigna s affordability commitment within Cigna International s business This role is responsible for detecting and recovering fraudulent waste or abusive FWA payments creating solutions to prevent claims overpayment and future spend monitoring He She will work closely with other Payment Integrity PI team members Network Medical Economics Data Analytics Claims Operations Clinical partners and Product Responsibilities Identify and Investigate potential instances of fraud waste or abuse FWA across all Cigna s International Markets books of business for claims incurred Seek recovery of FWA payments from claim submissions Ensure savings are tracked and reported accurately Work in partnership to implement solutions and drive execution to prevent claims overpayment unnecessary claim spend and ensure timeliness and accuracy of PI claims review process Perform data-mining to reveal FWA trends and patterns Partner with Cigna TPAs on FWA investigations Partner with Payment Integrity teams in other locations to share FWA claiming schemes Partner with Data Analytics team in building future FWA triggers automation Provide investigation reports to internal and external stakeholders 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 within Healthcare or similar discipline strongly desired Minimum of 2 years of health insurance claims experience or health care provider experience Knowledge of claims coding regulatory rules and medical policy Medical paramedical qualification is a definite plus Critical mind-set with ability to identify cost containment opportunities Experience with data analytics is a robust asset Strong attention to detail Excellent verbal and written communication skills Flexibility to work with global teams and varying time zones effectively Confidence to liaise with internal stakeholders Strong organization skills with the ability to juggle priorities and work under pressure to meet tight deadlines Experience of full Microsoft suite Fluency in foreign languages in addition to fluent English is a strong plus About The Cigna Group 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

📌 Fraud Analyst (Karnataka)
🏢 The Cigna Group
📍 Karnataka