Regional Medical Fraud & Payment Integrity Analyst

Cigna Healthcare; Riyadh; On-site; SAR 180,000 - 280,000; Full time

Job summary

The Cigna Group in Saudi Arabia invites applications for the Medical Fraud Senior Analyst – Payment Integrity FWA Regional Team. This role supports affordability commitments and detects and recovers FWA payments for non-network claims within the KSA region.

You will work with PI, Network, Data Analytics, Claims Operations and Compliance to prevent overpayments, identify trends, and ensure timely reviews while maintaining regulatory compliance. Fluency in English and Arabic is required.

Qualifications

• Minimum of 4 years of health insurance or health care provider experience.
• Knowledge of claims coding, local regulatory rules and medical policy.
• Fluency in Arabic in addition to fluent English is a must.
• Experience of investigation within payment integrity or similar discipline.
• Strong organization skills and attention to detail.

Responsibilities

• Identify and investigate potential instances of FWA or error across a dedicated region.
• Perform prepay cost avoidance activities and seek recovery of FWA payments.
• Research and analyze data to identify possible FWA cases with appropriate actions.
• Identify trends and patterns of insurance fraud through data analysis.
• Collaborate with investigators and stakeholders to implement preventive solutions.
• Ensure PI savings are tracked and reported accurately.
• Work with global teams to share FWA schemes and develop future triggers.

Skills

Data analytics

Investigation skills

Communication skills

Multitasking

Team collaboration

Fluency in English

Fluency in Arabic

Education

Medical/paramedical qualification

Job description

The Cigna Group in Saudi Arabia invites applications for the Medical Fraud Senior Analyst – Payment Integrity FWA Regional Team. This role supports affordability commitments and detects and recovers FWA payments for non-network claims within the KSA region.

You will work with PI, Network, Data Analytics, Claims Operations and Compliance to prevent overpayments, identify trends, and ensure timely reviews while maintaining regulatory compliance. Fluency in English and Arabic is required.