Quality Review and Audit Analyst- Cigna Healthcare

Overview

Delivers professional activities in the Quality Review and Audit job family, applying standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.

What you'll do

• Applies standard techniques and procedures to routine instructions that require professional knowledge in specialist areas.
• Provides standard professional advice and creates initial reports/analyses for review.
• Develops and distributes audit reports.
• Assists with third party audits by completing questionnaires, validating selected claims, responding to errors, etc.
• Identifies and recommends changes to improvements in department processing and procedures, and assists in the development of audit guidelines.
• May act as subject matter expert and a resource for team members.
• May develop and/or recommend training programs to address error trends.
• May provide guidance, coaching, and direction to more junior members of the team in Quality Review and Audit.