International Payment Integrity & Prepay Fraud Lead

Cigna Health and Life Insurance Company; Kuala Lumpur; On-site; MYR 80,000 - 120,000; Full time

Job summary

Cigna Health and Life Insurance Company is seeking a Quality Review and Audit Prepay Supervisor to lead regional prepayment teams in identifying questionable claims and enforcing policy adherence across international markets.

The role emphasizes fraud prevention, data-informed decision making, and cross-functional collaboration to meet savings targets while maintaining service quality. A strong background in health insurance and analytics is preferred.

Qualifications

• Experience in health insurance or international care providers is required.
• Minimum 2 years in health insurance or international health care provider roles.
• Minimum 1 year in a Payment Integrity function is preferred.
• Fluent English with additional languages a strong plus.
• Ability to manage multiple priorities and meet timelines.

Responsibilities

• Lead remote, regionally focused prepayment teams to identify non-payment and potential Fraud, Waste and Abuse.
• Coordinate with PI management to execute plans and meet KPIs.
• Monitor and report PI savings and department performance.
• Ensure compliance with legal, regulatory and contractual requirements.
• Oversee onboarding, training, and performance appraisals of team members.
• Provide feedback across departments to prevent risk exposure and safeguard customers.
• Develop and communicate presentations and training materials.

Skills

Organizational skills

Attention to detail

Rapid learning

Data analysis

Excel proficiency

PowerPoint

Communication skills

Team collaboration

Independent work

Tools

Microsoft Excel

Word

PowerPoint

Outlook

SharePoint

Job description

Cigna Health and Life Insurance Company is seeking a Quality Review and Audit Prepay Supervisor to lead regional prepayment teams in identifying questionable claims and enforcing policy adherence across international markets.

The role emphasizes fraud prevention, data-informed decision making, and cross-functional collaboration to meet savings targets while maintaining service quality. A strong background in health insurance and analytics is preferred.