Quality Audit Analyst

CIGNA Worldwide General Insurance Company Limited; Kuala Lumpur; Presencial; MYR 60.000 - 90.000; Jornada completa

Descripción de la vacante

CIGNA Worldwide General Insurance Company Limited is seeking a Quality Audit Analyst to safeguard service delivery quality across operations. You will conduct audits, review case accuracy, identify gaps, and ensure compliance with internal procedures and regulatory guidelines.

You will provide actionable feedback, support continuous improvement, and collaborate with team leaders to maintain high standards. This role bridges frontline teams, supervisors, and quality leaders, bringing

Formación

• 3–5 years of experience in operations or quality roles.
• Strong knowledge of operational processes across claims, eligibility, admin or service.
• Excellent analytical and data interpretation skills.
• Clear written and verbal feedback abilities.

Responsabilidades

• Conduct routine and targeted audits across operational workstreams (e.g., Claims, Eligibility, Admin, Customer Service, Client Support).
• Assess accuracy, completeness, compliance, and alignment to SOPs and regulatory requirements.
• Review system entries, documentation, case handling, and communication quality.
• Ensure audit scoring is objective, consistent, and aligned with the quality framework.
• Provide clear, constructive audit feedback to team members and supervisors.
• Highlight high‑risk errors and recurring themes that require escalation.
• Support team leaders in delivering quality coaching sessions.
• Maintain accurate audit logs and records for reporting & governance.
• Identify potential compliance gaps, regulatory breaches, or quality risks.
• Escalate critical findings promptly to supervisors and Quality leads.
• Support adherence to audit requirements for internal control, risk management, and governance processes.
• Recommend improvements to processes, documentation, and training materials.
• Assist in revising SOPs or workflows when audit trends indicate the need for change.
• Identify opportunities for automation to improve process quality.
• Participate in mini‑projects or working groups aimed at service improvement.
• Define appropriate outcome-based metrics for aligned process
• Compile quality metrics, error trends, and monthly/quarterly dashboards.
• Support root‑cause analysis to identify systemic issues.
• Contribute to MOR input, audit summaries, and performance packs where required.
• Work closely with supervisors, trainers, SMEs, transitions and QA colleagues to maintain consistent quality standards.
• Support readiness for new releases, process changes, training classes or quality framework updates.
• Participate in calibration sessions to ensure fairness and consistency of audit scoring.

Conocimientos

Quality auditing

Analytical thinking

Attention to detail

Communication

Collaboration

Time management

Process discipline

Continuous improvement

Objectivity

Customer focus

Herramientas

Workflow systems

QA tools

CRM platforms

Excel

Descripción del empleo

CIGNA Worldwide General Insurance Company Limited View all jobs

As a Quality Audit Analyst, you play a key role in safeguarding operational excellence across service delivery teams. You will be responsible for conducting quality audits, reviewing case accuracy, identifying process gaps, and ensuring adherence to internal procedures, regulatory guidelines, and customer commitments.

You will provide actionable feedback to team leaders and staff, support continuous improvement, and contribute to building a culture of quality, compliance, and consistency across Operations.

This role acts as a bridge between frontline teams, supervisors, and quality leaders by bringing insight, evidence‑based recommendations, and root‑cause analysis into daily operations.

KEY RESPONSIBILITIES

Quality Review & Audit Execution

• Conduct routine and targeted audits across operational workstreams (e.g., Claims, Eligibility, Admin, Customer Service, Client Support).
• Assess accuracy, completeness, compliance, and alignment to SOPs and regulatory requirements.
• Review system entries, documentation, case handling, and communication quality.
• Ensure audit scoring is objective, consistent, and aligned with the quality framework.

Insights, Feedback & Coaching Support

• Provide clear, constructive audit feedback to team members and supervisors.
• Highlight high‑risk errors and recurring themes that require escalation.
• Support team leaders in delivering quality coaching sessions.
• Maintain accurate audit logs and records for reporting & governance.

Risk & Compliance Support

• Identify potential compliance gaps, regulatory breaches, or quality risks.
• Escalate critical findings promptly to supervisors and Quality leads.
• Support adherence to audit requirements for internal control, risk management, and governance processes.
• Recommend improvements to processes, documentation, and training materials.
• Assist in revising SOPs or workflows when audit trends indicate the need for change.
• Identify opportunities for automation to improve process quality.
• Participate in mini‑projects or working groups aimed at service improvement.

Data & Reporting

• Define appropriate outcome-based metrics for aligned process
• Compile quality metrics, error trends, and monthly/quarterly dashboards.
• Support root‑cause analysis to identify systemic issues.
• Contribute to MOR input, audit summaries, and performance packs where required.
• Work closely with supervisors, trainers, SMEs, transitions and QA colleagues to maintain consistent quality standards.
• Support readiness for new releases, process changes, training classes or quality framework updates.
• Participate in calibration sessions to ensure fairness and consistency of audit scoring.

YOUR PROFILE

• Minimum 3-5 years experience in an operations or quality‑related role.
• Strong understanding of operational processes (claims, eligibility, admin or service preferred).
• Good working knowledge of operational systems and tools (e.g., workflow systems, QA tools, CRM platforms, Excel).
• Excellent attention to detail and accuracy.
• Strong analytical capability with ability to interpret data and identify trends.
• Clear communicator, capable of giving balanced and constructive feedback.
• Ability to prioritise workload, manage deadlines, and work independently.
• Strong problem‑solving skills and process‑driven mindset.
• Customer‑focused, with a commitment to driving quality and service improvement.
• Fluent in English; additional languages are an advantage.
• Demonstrates integrity, fairness, and objectivity in audit assessment.

KEY COMPETENCIES

• Quality Orientation – Focuses on compliance, accuracy, and error‑free output.
• Analytical Thinking – Uses data, patterns, and root‑cause reasoning.
• Attention to Detail – Diligent and precise in reviewing casework.
• Collaboration – Builds constructive relationships with supervisors and staff.
• Communication – Provides clear written and verbal audit feedback.
• Time Management – Manages audit volumes and deadlines effectively.
• Process Discipline – Follows frameworks, SOPs, and governance standards.
• Continuous Improvement Mindset – Identifies improvement opportunities.
• Objectivity & Fairness – Ensures unbiased audit scoring.
• Customer Focus – Drives outcomes that protect customer experience.

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.

Quality Audit Analyst – Band 2

YOUR JOB

As a Quality Audit Analyst, you play a key role in safeguarding operational excellence across service delivery teams. You will be responsible for conducting quality audits, reviewing case accuracy, identifying process gaps, and ensuring adherence to internal procedures, regulatory guidelines, and customer commitments.

You will provide actionable feedback to team leaders and staff, support continuous improvement, and contribute to building a culture of quality, compliance, and consistency across Operations.

This role acts as a bridge between frontline teams, supervisors, and quality leaders by bringing insight, evidence‑based recommendations, and root‑cause analysis into daily operations.

KEY RESPONSIBILITIES

Quality Review & Audit Execution

• Conduct routine and targeted audits across operational workstreams (e.g., Claims, Eligibility, Admin, Customer Service, Client Support).
• Assess accuracy, completeness, compliance, and alignment to SOPs and regulatory requirements.
• Review system entries, documentation, case handling, and communication quality.
• Ensure audit scoring is objective, consistent, and aligned with the quality framework.

Insights, Feedback & Coaching Support

• Provide clear, constructive audit feedback to team members and supervisors.
• Highlight high‑risk errors and recurring themes that require escalation.
• Support team leaders in delivering quality coaching sessions.
• Maintain accurate audit logs and records for reporting & governance.

Risk & Compliance Support

• Identify potential compliance gaps, regulatory breaches, or quality risks.
• Escalate critical findings promptly to supervisors and Quality leads.
• Support adherence to audit requirements for internal control, risk management, and governance processes.

Continuous Improvement

• Recommend improvements to processes, documentation, and training materials.
• Assist in revising SOPs or workflows when audit trends indicate the need for change.
• Identify opportunities for automation to improve process quality.
• Participate in mini‑projects or working groups aimed at service improvement.

Data & Reporting

• Define appropriate outcome-based metrics for aligned process
• Compile quality metrics, error trends, and monthly/quarterly dashboards.
• Support root‑cause analysis to identify systemic issues.
• Contribute to MOR input, audit summaries, and performance packs where required.

Cross‑Team Collaboration

• Work closely with supervisors, trainers, SMEs, transitions and QA colleagues to maintain consistent quality standards.
• Support readiness for new releases, process changes, training classes or quality framework updates.
• Participate in calibration sessions to ensure fairness and consistency of audit scoring.

YOUR PROFILE

• Minimum 3-5 years experience in an operations or quality‑related role.
• Strong understanding of operational processes (claims, eligibility, admin or service preferred).
• Good working knowledge of operational systems and tools (e.g., workflow systems, QA tools, CRM platforms, Excel).
• Excellent attention to detail and accuracy.
• Strong analytical capability with ability to interpret data and identify trends.
• Clear communicator, capable of giving balanced and constructive feedback.
• Ability to prioritise workload, manage deadlines, and work independently.
• Strong problem‑solving skills and process‑driven mindset.
• Customer‑focused, with a commitment to driving quality and service improvement.
• Fluent in English; additional languages are an advantage.
• Demonstrates integrity, fairness, and objectivity in audit assessment.

KEY COMPETENCIES

• Quality Orientation – Focuses on compliance, accuracy, and error‑free output.
• Analytical Thinking – Uses data, patterns, and root‑cause reasoning.
• Attention to Detail – Diligent and precise in reviewing casework.
• Collaboration – Builds constructive relationships with supervisors and staff.
• Communication – Provides clear written and verbal audit feedback.
• Time Management – Manages audit volumes and deadlines effectively.
• Process Discipline – Follows frameworks, SOPs, and governance standards.
• Continuous Improvement Mindset – Identifies improvement opportunities.
• Objectivity & Fairness – Ensures unbiased audit scoring.
• Customer Focus – Drives outcomes that protect customer experience.

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.

Unlock job insights

Hirer responsiveness Salary match Number of applicants

Whatever your health insurance needs, our International Medical Plans can be tailored to meet them, while always offering a global support network of hospitals and medical professionals.

Whole health is a new way to think about care that allows Cigna to look at the full picture. To widen its scope, to acknowledge the full spectrum of factors that make up who you are and how you feel at any given time. So that, ultimately, we can help people live their lives in full – the good, the bad and every moment in between, knowing that you are supported in every aspect of your world.

Whatever your health insurance needs, our International Medical Plans can be tailored to meet them, while always offering a global support network of hospitals and medical professionals.

Whole health is a new way to think about care that allows Cigna to look at the full picture. To widen its scope, to acknowledge the full spectrum of factors that make up who you are and how you feel at any given time. So that, ultimately, we can help people live their lives in full – the good, the bad and every moment in between, knowing that you are supported in every aspect of your world.

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