# Fraud Analyst (Pre-Pay)

**Company**: Cigna Healthcare
**Location**: Kenya One Africa Place
**Experience**: senior
**Job type**: full-time
**Category**: Insurance
**Industry**: Healthcare

**Apply**: https://cigna.wd5.myworkdayjobs.com/en-US/cignacareers/job/Kenya-One-Africa-Place/Fraud-Analyst---Cigna-Healthcare--5-Months-Fixed-Term-Contract-_26011723-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_b41cd61f-b4f

## Description

Cigna Healthcare is seeking a Fraud Analyst (Pre-Pay) to join the Payment Integrity Department. As a Fraud Analyst, you will play a crucial role in identifying and preventing fraudulent, wasteful, and abusive expenses globally. You will support the Payment Integrity FWA Team with client reporting and contribute to healthcare affordability initiatives.

**Responsibilities:**

- Manage the team mailbox and respond or direct enquiries appropriately.

- Act as the initial review point for possible fraudulent claims.

- Identify claims with potential waste and abuse.

- Provide initial review and research to determine if claims require further investigation.

- Contact providers to request documents and confirm information.

- Uphold documentation and process standards.

- Partner with cost containment teams to share best practices.

- Participate in projects to improve business processes.

- Ensure team savings are tracked and reported accurately.

- Collaborate with Payment Integrity teams to share FWA claiming schemes.

- Work with the Data Analytics team to build future FWA triggers automation.

- Support the production of investigation reports for internal and external stakeholders.

**Requirements:**

- Minimum of 2 years of experience in a health insurance fraud or payment integrity environment, with a strong preference for fraud investigation experience.

- Knowledge of claims coding, regulatory rules, and medical policy.

- Medical or paramedical qualification is a definite plus.

- Demonstrated strong organization skills.

- Strong attention to detail.

- Ability to quickly learn new and complex tasks and concepts.

- Critical mindset with the ability to identify cost containment opportunities.

- Excellent verbal and written communication skills.

- Ability to balance multiple priorities and deliver on tight timelines.

- Flexibility to work with global teams and varying time zones effectively.

- Confidence to deal with internal stakeholders and work with cross-functional teams.

- Fluency in foreign languages in addition to fluent English is a strong plus.

**Benefits:**

- Competitive salary and Private Medical Insurance.

- Multicultural and hybrid working environment.

- Opportunity to work with global teams and contribute to healthcare affordability initiatives.

## Skills

### Required
- claims coding
- regulatory rules
- medical policy
- fraud investigation
- cost containment
- data analytics
- team collaboration

### Nice to have
- medical or paramedical qualification
- fluency in foreign languages

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Source: [Apply at cigna.wd5.myworkdayjobs.com](https://cigna.wd5.myworkdayjobs.com/en-US/cignacareers/job/Kenya-One-Africa-Place/Fraud-Analyst---Cigna-Healthcare--5-Months-Fixed-Term-Contract-_26011723-1?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)