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Fraud Analyst – Integrity

Trabajo disponible en: 04810, Madrid, Andalucia, España
Empresa: Cigna Health and Life Insurance Company
Tiempo completo puesto
Publicado en 2026-06-24
Especializaciones laborales:
  • Finanzas
    Analista financiero, Cumplimiento Financiero, Informes Financieros, Gerente/Analista de Riesgos
Rango Salarial o Referencia de la Industria: 40000 - 60000 EUR Anual EUR 40000.00 60000.00 YEAR
Descripción del trabajo
Puesto: Fraud Analyst – Payment Integrity

Cigna Healthcare, a division of The Cigna Group, is a global health services company dedicated to improving the health, wellbeing, and peace of mind of those we serve. Operating in over 30 countries, Cigna supports more than 190 million customer relationships worldwide through medical, dental, behavioral health, pharmacy, and vision care solutions.

Fraud Analyst – Payment Integrity Global Investigation Unit

As Fraud Analyst within the Global Investigation Unit you will be directly supporting Cigna’s affordability commitment within Cigna International's business. This role is responsible for detecting and recovering fraudulent, waste or abusive (FWA) payments, creating solutions to prevent claims over payment and future spend monitoring. He/She will work closely with other Payment Integrity (PI) team members, Network, Medical Economics, Data Analytics, Claims Operations, Clinical partners and Product.

Responsibilities
  • Identify and investigate potential instances of fraud, waste or abuse (FWA) across claims and payment card activity, driving timely, consistent decision‑making and effective investigation outcomes.
  • Conduct transaction monitoring, analytical reviews and data mining to identify unusual patterns, anomalies, and emerging FWA risks across card‑enabled claims and transactions.
  • Manage chargeback activity and recovery outcomes where inappropriate payments are identified, ensuring savings are accurately tracked and reporting is clear and timely.
  • Partner with operational teams to configure, strengthen, and monitor payment integrity controls, contributing to continuous improvement of workflows to enhance accuracy, efficiency and timeliness.
  • Provide investigation reports to internal and external stakeholders.
  • Partner with Payment Integrity teams in other locations to share FWA claiming schemes.
  • Partner with Data Analytics team in building future FWA triggers automation.
  • Partner with Cigna TPAs on FWA investigations.
  • Proactively monitor industry information and bulletins to assess impact to the company.
Skills and Requirements
  • Minimum of 2 years’ experience in fraud investigation, payment integrity, card fraud or a related discipline.
  • Minimum of 2 years’ experience in health insurance claims processing, health care provider operations or similar environment.
  • Strong understanding of payment card ecosystems, dispute and chargeback processes, and fraud typologies, with demonstrated capability in transaction‑level analysis and application of risk controls.
  • Experience with data analytics and investigative use of data is a strong asset.
  • Strong analytical mindset with ability to identify cost containment opportunities.
  • High attention to detail, with the ability to produce accurate, well‑documented investigative outputs.
  • Excellent verbal and written communication skills, with confidence engaging internal stakeholders and external partners.
  • Knowledge of claims coding, regulatory requirements and medical policy preferred.
  • Medical/paramedical qualification is an advantage.
  • Flexibility to work with global teams and varying time zones effectively.
  • Strong organization skills with the ability to manage competing priorities and work effectively under pressure to meet tight deadlines.
  • Proficient in the full Microsoft suite.
  • Fluency in additional languages beyond English is a strong plus.
  • Enjoys working in a high‑performing, collaborative team environment with shared accountability for outcomes.
What We Offer
  • The opportunity to work in a global, diverse and collaborative environment.
  • Exposure to cross‑functional teams and strategic projects.
  • A culture that supports learning, development and internal career growth.
  • A role with real impact on business performance and healthcare affordability.
  • A supportive and inclusive workplace that values innovation and continuous improvement.
  • A competitive benefits package, including a range of social benefits (location dependent).
  • A hybrid working model and flexible working hours to support work‑life balance.

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.

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