Global Fraud Analyst (Pre-Pay) – Claims & FWA

Cigna Healthcare; Madrid; Presencial; EUR 42.000 - 62.000; Jornada completa

Descripción de la vacante

Cigna Healthcare in Madrid is seeking a Fraud Analyst (Pre-Pay) to identify and prevent fraudulent, wasteful and abusive expenses within the global footprint. You will support the Payment Integrity FWA Team with client reporting and collaborate with cross‑functional teams to drive cost containment.

The role requires strong analytical skills, attention to detail, and the ability to work with multiple stakeholders in a fast-paced environment.

Formación

• Experience in fraud investigation is strongly desired.
• Minimum of 2 years in health insurance or health care provider roles.
• Knowledge of claims coding, regulatory rules, and medical policy.

Responsabilidades

• Manages team mailbox and forwards inquiries.
• Acts as initial review point for potential fraudulent claims.
• Identifies claims with waste and abuse potential.
• Provides initial review and research to determine if further investigation is needed.
• Contacts providers requesting documents and confirming information.
• Upholds documentation and process standards.
• Partners with cost containment teams across geographies.

Conocimientos

Fraud investigation

Health insurance

Claims processing

Diamond system

Communication

Global collaboration

Project coordination

Descripción del empleo

Cigna Healthcare in Madrid is seeking a Fraud Analyst (Pre-Pay) to identify and prevent fraudulent, wasteful and abusive expenses within the global footprint. You will support the Payment Integrity FWA Team with client reporting and collaborate with cross‑functional teams to drive cost containment.

The role requires strong analytical skills, attention to detail, and the ability to work with multiple stakeholders in a fast-paced environment.