Fraud Analyst

The job profile for this position is Fraud Analyst (Pre-Pay), a Band 2 Senior Contributor Career Track Role.

Role Summary :

As Fraud Analyst (Pre-Pay) within the Payment Integrity Fraud Investigation Unit, you will support Cigna's affordability commitment within Cigna International's business. This role is responsible for identifying and preventing fraudulent, wasteful, and abusive expenses globally, and supporting the Fraud Investigation Team with client reporting.

Responsibilities include managing the team mailbox, acting as the initial review point for potential fraudulent claims, identifying operational errors to prevent incorrect payments, conducting initial reviews and research, contacting providers and members for documents, sharing best practices with other geographies, participating in process improvement projects, ensuring team savings are tracked and reported, collaborating with other teams on FWA schemes and automation, and supporting investigation reporting with proper evidence management.

Skills and Requirements :

• Enjoy working in a high-performing team with accountability.
• Strongly desired experience in fraud investigation.
• Minimum of 2 years in health insurance or healthcare provider roles.
• Competent in processing or investigating claims on Mainframe.
• Knowledge of claims coding, regulatory rules, and medical policy.
• Medical or paramedical qualification is a plus.
• Strong organizational skills and attention to detail.
• Ability to learn complex tasks quickly.
• Critical thinking to identify cost containment opportunities.
• Excellent communication skills.
• Ability to manage multiple priorities under tight deadlines.
• Flexibility to work across global teams and time zones.
• Confidence in stakeholder communication and cross-functional teamwork.
• Fluency in additional languages is a strong plus.

Work location: Hybrid model (home and office).

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, advocates for better health at every life stage. We guide customers through the healthcare system, empowering them to make informed health decisions. Join us to drive growth and improve lives.

Qualified applicants will be considered regardless of race, color, age, disability, sex, pregnancy, medical conditions, sexual orientation, gender identity, veteran status, religion, national origin, genetic information, public assistance, citizenship, or other protected characteristics. Reasonable accommodations are available upon request.

Required Experience :

Key Skills include Microsoft Office, Risk Management, Financial Services, Customer Service, Fraud, Root Cause Analysis, Law Enforcement, Banking, Analysis Skills, Authentication, Qualitative Research, Interviewing, ACH.

Employment Type: Full-Time

Experience: 2+ years

Vacancy: 1