Quality Review And Audit Senior Representative

Cigna

Bengaluru, India
Claim processing guidelines
Diamond claim role applications
Quality assurance auditing process
This position will be responsible for auditing the work within the CGHB Organization, driving change and positively impacting accuracy and efficiency

Job Summary

  • This position will be responsible for auditing the work within the CGHB Organization, driving change and positively impacting accuracy and efficiency.
  • Responsibilities include completing audits to ensure claim advocates understand Cigna policies, procedures, and guidelines, and interfacing with partners to address identified gaps.
  • The role involves providing feedback to operations, participating in inter-rater reliability exercises, and supporting coaching and training programs.

Matching Summary

This position will be responsible for auditing the work within the CGHB Organization, driving change and positively impacting accuracy and efficiency.

Skills & Requirements

Must-have

  • Claim processing guidelines
  • Diamond claim role applications
  • Quality assurance auditing process
  • Inter-rater reliability exercises
  • Review of audit documents

Nice-to-have

  • Customer service driven
  • Problem solving skills
  • Process improvement skills
  • Adaptable to diverse environments
  • Strong organization and time management

Key Requirements

  • 2+ years overall claims processing experience
  • 1+ year Diamond claim processing experience
  • US & International claims experience preferred

Work Rights

Not specified

Tailored Resume

Cover Letter