Quality Assurance Senior Rep

• Job Description Summary
• Job Description

Responsibilities

• Participates in complex audits, third party audits, ad-hoc projects and assignments as defined by the Quality Auditor Team Manager.
• Performs root cause analysis on audit findings to understand why the findings occurred.
• Agrees suitable action plans to remove root causes and prevent findings from recurring. 
• Monitors performance trends and agrees suitable action plans to address these trends. 
• Identifies improvements to both audit and operational processes and procedures.                                                                                                                                                                                                             
• Collates and reports audit findings to Senior Management accurately and on time.
• Assists in the development of audits and audit processes and procedures.
• Acts as a subject matter expert who supports their fellow Auditors.

 

                                                                                                                                           

Experience & Competencies

 

• 2 years’ experience in Middle East Insurance Market
• 2 years’ experience in medical claims and/or an auditing role
• Excellent Arabic and English skills, verbal and written.
• Ideally NAS Neuron experience of at least 1 year
• Medical background preferred.                                                                                                                                                                                 
• High energy, results-oriented individual able to coordinate and prioritize multiple tasks to meet deadlines.
• Ability to think analytically, interpret information / observations and make effective decisions.
• Ability to ask for guidance, when required, on complex issues.
• Professional verbal and written communication skills.
• Ability to listen attentively, build rapport and ask structured open / closed questions.
• Ability to diffuse and resolve instances of conflict.
• Ability to produce clear and factual reports.
• Ability to present information and ideas in a confident, creative, and interactive manner.
• Ability to explain audit findings and trends and provide constructive feedback; work patiently and effectively with staff of different experience levels, learning styles and cultural diversity.
• Ability to provide constructive coaching to fellow Auditors to share knowledge and skills.
• Ability to work effectively on their own and as part of a team.
• Mindful of the needs of the business and the personal needs of the person being audited.

Job Description

Delivers specific delegated Quality Assurance/Audit tasks assigned by a supervisor. Completes day-to-day Quality Review and Audit tasks without immediate supervision, but has ready access to advice from more experienced team members. Identifies and recommends changes to improvements in department processing and procedures, and assists in the development of audit guidelines.  Requires seasoned knowledge of accounting and auditing procedures and systems expertise for auditing structure or claim payments.  Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members.

Job Description Summary

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.