The job profile for this position is a Quality Review and Audit Senior Analyst, which is a Band 3 Senior Contributor Career Track Role.
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Role Summary
A Recovery Senior Analyst you will be directly supporting Cigna's affordability commitment within Cigna International's business. This role is responsible for to identifying, investigate and seeking recoveries for subrogation cases across Cigna's Global claims platforms. He/ She will work closely with Claims Operations, Clinical partners, Legal and Compliance, Account Management and Data Analytics.
Responsibilities
- Review clams and supporting documents to identify third party liability that caused injuries to Cigna insured.
- Interview customer, provider and/ or third-parties to establish liability and opportunity.
- Seek recovery of payments from third-parties responsible for the health damages caused to the insured or third-party insurer.
- Negotiate settlement agreements.
- Partner with external Legal vendors.
- Partner with Customer Services and Account Management on educating customers and clients regarding the subrogation rights and obtaining required documentation.
- Ensure cases are tracked and reported accurately.
- Perform data-mining to reveal trends and patterns of subrogation cases.
- Partner with Cigna TPAs on subrogation cases.
- Partner with Payment Integrity and other teams to raise awareness of schemes that fall under subrogation scope.
- Provide ongoing operational analysis of process components, while identifying and implementing changes as necessary to improve the level of quality and efficiency as measured by key performance indicators.
- Working closely with other departments to ensure Payment Integrity activities do not have an unnecessary negative impact on our customers.
Skills And Requirements
- You should enjoy working in a team of high performers, who hold each other accountable to perform to their very best.
- Experience and confidence in liaising with internal and external stakeholders.
- Commercial experience operating effectively under pressure and delivering results.
- Knowledge of Mainframe, Diamond, Actisure and/or Globalcare is preferred.
- Ability to negotiate settlement agreements.
- Critical mind-set with ability to understand regulatory and legal context.
- Experience with data analytics is plus.
- Demonstrated strong organization skills.
- Strong attention to detail.
- Ability to quickly learn new and complex tasks and concepts.
- Excellent communication skills.
- Ability to balance multiple priorities at once and deliver on tight timelines.
- Flexibility to work with global teams and varying time zones effectively.
- Strong organization skills with the ability to juggle priorities and work under pressure to meet tight deadlines.
- Dedicated to meeting the expectations and requirements of internal and external customers, excellent at building effective relationships and gaining trust and respect.
- Fluency in foreign languages in addition to fluent English is a strong plus.
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.
