Description
We are seeking a Hospital Inspector to join our Clinical Management team. As a Hospital Inspector, you will be the eyes of the company in the hospital and the voice of the hospital in the company.
Job Objectives:
- Control medical expenses
- Optimize hospital stays
- Review hospital billing
- Improve customer experience for hospitalized patients
Key Responsibilities:
- Monitor patient census and track hospital admissions
- Review and control hospital billing
- Enhance customer experience with Cigna's insurance services
- Provide support to call center for clinical advice
- Refer patients to Case Management
- Manage and control medical expenses (hospitals and healthcare professionals)
- Oversee authorization, provision, and billing processes
- Identify Fraud, Waste, and Abuse (FWA)
- Design and implement cost-efficient procedures by specialty
- Manage hospital bed allocation
- Negotiate with suppliers: annual rates, reconciliation of billing differences
- Implement electronic billing for suppliers
- Develop and negotiate supplier tariffs
Requirements:
- Nursing degree
- +3 years of experience in an insurance company or hospital administration/billing
- Clinical experience in a hospital setting is desirable
Desirable Requirements:
- High level of English (desirable)
What We Offer:
- Permanent contract
- Comprehensive benefits package: medical, dental, life, and vision insurance; meal and telework allowances; Wellhub, wellness programs, and language training
- Opportunity to directly impact care quality and customer experience
- Hybrid model with flexible schedule: Monday to Thursday, 9:00 AM - 6:15 PM, Friday, 9:00 AM - 2:45 PM
- 27 vacation days plus birthday off
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