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Quality Review and Audit Analyst- Cigna Healthcare

BengaluruHybridFull-time

AI Summary

Conducts quality reviews and audits, develops audit reports, validates claims, and recommends process improvements in healthcare operations.

About this role

Delivers professional activities in the Quality Review and Audit job family. Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas. Provides standard professional advice and creates initial reports/analyses for review. Develops and distributes audit reports. Assists with third party audits by completing questionnaires, validating selected claims, responding to errors, etc. Identifies and recommends changes to improvements in department processing and procedures, and assists in the development of audit guidelines. May act as subject matter expert and a resource for team members. May develop and/or recommend training programs to address error trends. May provide guidance, coaching, and direction to more junior members of the team in Quality Review and Audit.

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.

Skills

AuditClaims ValidationHealthcare OperationsProcess ImprovementQuality ReviewReportingThird-party AuditTraining Development

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