Quality Assurance Senior Rep

Role Overview

Quality Assurance Senior Rep at Cigna. This role delivers specific delegated Quality Assurance and Audit tasks with minimal direct supervision, working within the Quality Auditor Team to support claims and process integrity.

Company Overview

The Cigna Group is dedicated to improving the health and vitality of those served through its divisions Cigna Healthcare and Evernorth Health Services, committed to enhancing the lives of clients, customers and patients.

Role Purpose

To execute quality assurance and audit functions with seasoned knowledge of accounting, auditing procedures and systems, identifying process improvements and providing mentorship to junior team members while resolving non-routine issues escalated from the wider audit team.

Key Responsibilities

Audit Execution

• Participate in complex audits, third-party audits, ad-hoc projects and assignments as defined by the Quality Auditor Team Manager.
• Complete day-to-day Quality Review and Audit tasks without immediate supervision.
• Perform root cause analysis on audit findings to understand why findings occurred.

Process Improvement & Analysis

• Identify improvements to both audit and operational processes and procedures.
• Recommend changes to improvements in department processing and procedures.
• Assist in the development of audits, audit processes, procedures and audit guidelines.
• Monitor performance trends and agree suitable action plans to address these trends.

Action Planning & Resolution

• Agree suitable action plans to remove root causes and prevent findings from recurring.
• Resolve non-routine issues escalated from more junior team members.

Reporting & Communication

• Collate and report audit findings to Senior Management accurately and on time.
• Produce clear and factual reports.
• Explain audit findings and trends and provide constructive feedback.

Team Support

• Act as a subject matter expert who supports fellow Auditors.
• Provide constructive coaching to fellow Auditors to share knowledge and skills.
• Work patiently and effectively with staff of different experience levels, learning styles and cultural diversity.

Qualifications & Experience

• 2 years' experience in Middle East Insurance Market.
• 2 years' experience in medical claims and/or an auditing role.
• Ideally NAS Neuron experience of at least 1 year.
• Medical background preferred.
• Seasoned knowledge of accounting and auditing procedures and systems expertise for auditing structure or claim payments.

Skills & Competencies

• Excellent Arabic and English skills, verbal and written.
• High energy, results-oriented individual able to coordinate and prioritize multiple tasks to meet deadlines.
• Ability to think analytically, interpret information and observations and make effective decisions.
• Ability to ask for guidance when required on complex issues.
• Professional verbal and written communication skills.
• Ability to listen attentively, build rapport and ask structured open and closed questions.
• Ability to diffuse and resolve instances of conflict.
• Ability to present information and ideas in a confident, creative, and interactive manner.
• Ability to work effectively on their own and as part of a team.
• Mindful of the needs of the business and the personal needs of the person being audited.

Additional Information

• Tasks involve a degree of forward planning and anticipation of needs and issues.
• Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.