Regional Prepay Fraud & Payment Integrity Supervisor

Cigna Healthcare; Kuala Lumpur; On-site; MYR 90,000 - 130,000; Full time

Job summary

Cigna Healthcare in Malaysia seeks a Quality Review and Audit Prepay Supervisor to lead a regional prepayment team focused on identifying and preventing fraudulent, wasteful, and abusive expenses within Cigna International's business.

You will collaborate with Payment Integrity, Network, Medical Economics, Data Analytics, Claims Operations, Clinical partners, and MIU to meet KPIs, coach staff, monitor processes, and ensure compliance with legal and contractual requirements.

Qualifications

• Minimum of 2 years of health insurance or international health care provider experience.
• Experience with prepayment or payment integrity processes is preferred.
• Fluency in additional languages is a strong plus.

Responsibilities

• Lead regional Prepayment team to identify claims not to be paid as received and pursue Fraud, Waste and Abuse savings.
• Collaborate with PI management to execute plans and priorities.
• Coach staff and monitor compliance in billing and claims payment within international markets.
• Ensure KPIs are met and PI savings are accurately tracked and reported.
• Drive process improvements and risk mitigation across departments.
• Support onboarding and training of new hires.

Skills

Organizational skills

Attention to detail

Fast learner

Data analysis

Effective communication

Team collaboration

Multitasking

Tools

GlobalCare

Actisure

Excel

Word

PowerPoint

Outlook

SharePoint

Job description

Cigna Healthcare in Malaysia seeks a Quality Review and Audit Prepay Supervisor to lead a regional prepayment team focused on identifying and preventing fraudulent, wasteful, and abusive expenses within Cigna International's business.

You will collaborate with Payment Integrity, Network, Medical Economics, Data Analytics, Claims Operations, Clinical partners, and MIU to meet KPIs, coach staff, monitor processes, and ensure compliance with legal and contractual requirements.