Experteer Overview As Fraud Analyst (Pre-Pay) within the Payment Integrity Department, you help protect affordability by identifying and preventing fraudulent, wasteful, and abusive expenses globally. You will work with cross-functional teams to review claims, request documents, and support investigations, ensuring accurate reporting of savings. You’ll contribute to improving business processes and collaborating on automation initiatives with Data Analytics. This role offers impact across regions within a mission-driven healthcare organization.Compensaciones / Incentivos
- Manage team mailbox and route inquiries appropriately
- Act as initial review point for potential fraudulent claims
- Identify claims with potential waste and abuse
- Provide initial research to determine if further investigation is needed
- Request documents from providers and verify information
- Maintain documentation and process standards
- Share best practices with cost containment teams across geographies
- Participate in process-improvement projects
- Track and report team savings accurately




- Collaborate with Payment Integrity teams in other locations to share FWA schemes
- Partner with Data Analytics to build future FWA triggers automation
- Support production of investigation reports by compiling and storing evidenceResponsabilidades
- Experience in fraud investigation preferred
- Minimum 2 years in health insurance or health care provider experience
- Proficient in processing or investigating claims on Diamond
- Knowledge of claims coding, regulatory rules, and medical policy
- Medical/paramedical qualification a plus
- Strong organization and attention to detail
- Ability to learn new and complex tasks quickly
- Critical mindset with ability to identify cost containment opportunities
- Excellent verbal and written communication skills
- Ability to balance multiple priorities and meet tight timelines
- Willingness to work with global teams across time zones
- Fluency in additional languages is a strong plus
- Confidence in engaging internal stakeholders and cross-functional collaborationRequisitos principales
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📌 Fraud Analyst - Cigna Healthcare (Madrid)
🏢 Cigna
📍 Madrid