Fraud Analyst – Fixed‑Term (5 months) – Healthcare Payments
cigna · Kenya One Africa Place
Job description
About the role
Join Cigna Healthcare’s Payment Integrity Department as a Fraud Analyst (Pre‑Pay) on a 5‑month fixed‑term contract. You will help protect the organization’s affordability commitment by identifying and preventing fraudulent, wasteful, and abusive expenses worldwide.
Key responsibilities
- Manage the team mailbox, responding to or directing enquiries appropriately.
- Perform initial reviews of potentially fraudulent claims and identify waste or abuse.
- Contact providers to request documentation and verify information.
- Partner with cost‑containment and Payment Integrity teams across geographies to share best practices and FWA schemes.
- Support data‑analytics initiatives to build future FWA trigger automation.
- Compile and store evidence for investigation reports to internal and external stakeholders.
Required profile
- Minimum 2 years experience in health‑insurance or health‑care provider settings, preferably in fraud investigation.
- Knowledge of claims coding, regulatory rules and medical policy.
- Medical or paramedical qualification is a strong plus.
- Strong organization, attention to detail and ability to juggle multiple priorities under tight deadlines.
- Excellent verbal and written communication skills in English; additional language fluency is advantageous.
Required skills
- Claims coding knowledge.
- Understanding of regulatory and medical policy requirements.
- Ability to conduct document verification and evidence compilation.
What we offer
- Competitive salary and private medical insurance.
- Multicultural and hybrid working environment.
- Opportunity to work with global teams on healthcare affordability initiatives.
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Published 2 weeks ago
Expires 1 month from now
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cigna
Kenya One Africa Place
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