{"id":1217763,"url":"https://alion.io/job/the-cigna-group-payment-integrity-prepay-fraud-supervisor-cigna-healthcare","title":"Payment Integrity Prepay Fraud Supervisor - Cigna Healthcare","company":{"id":13928,"name":"The Cigna Group","domain":"thecignagroup.com","url":"https://alion.io/company/thecignagroup","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":90,"open_postings":54,"ghost_share":0,"stale_share":0.593,"repost_share":0.019,"time_to_fill_p50_days":15,"computed_at":"2026-09-25T05:45:01Z"}},"role":"Industrial Engineering","role_family":"Industrial Engineering","seniority":"junior","employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Kuala Lumpur, Malaysia"],"countries":["MY"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":11500,"max_usd":25000,"period":"year","method":"global_role_cell_scaled_by_country","sample_n":1608},"experience_years_min":2,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Excel","optional":true},{"name":"Outlook","optional":true},{"name":"SharePoint","optional":true}],"status":"live","first_seen_at":"2026-09-25T11:18:13Z","employer_posted_date":"2026-09-25","last_verified_at":"2026-09-26T00:40:10Z","board_verified":true,"closed_at":null,"days_open":0,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":0},"description":"Quality Review and Audit Prepay Supervisor\nThe job profile for this position is Quality Review and Audit Supervisor, which is a Band 3 Management Career Track Role.\nRole Summary:\nAs a Quality Review & Audit Supervisor within the Payment Integrity Pre-Payment Team you will be directly supporting Cigna’s affordability commitment within Cigna International's business.This role is responsible for leading remote, regionally focused prepayment team members who are responsible for identifying and preventing fraudulent, wasteful and abusive expenses within Cigna’s International Business Market. He/ She will work closely with other PI team members, Network, Medical Economics, Data Analytics, Claims Operations, Clinical partners, and Member Investigations Unit (MIU).\nResponsibilities:\nLead the Regional Prepayment team who are responsible for identifying claims that should not be paid as received and identify claims with potential Fraud, Waste and Abuse savings to meet Provider Integrity targets and KPIs. \nWorks closely with Payment Integrity management to understand strategy and is responsible for executing departmental plans and priorities.\nAccountable for managing internal stakeholder relationships.\nCoach and support all PI Pre-Payment team members to monitor and identify non-compliance in billing and claims payment activity within the international markets. \nEnsure department KPIs are met through effective monitoring and reporting mechanisms; ensure PI savings are tracked and reported accurately.\nExecutes strategic initiatives, plans, and goals in alignment with department KPIs and financial targets. \nEnsures payment integrity processes are in compliance with legal, regulatory and contractual requirements.\nAssess work demand against capacity to ensure optimum claim referrals across all referral routes; create solutions, drive execution and ensure timeliness and accuracy of PI claims review process. \nInstils work culture of continuous process improvement, innovation, and quality. \nOversee departmental personnel matters; evaluating staff performance and conducting performance appraisals for all direct reports. Ensure adherence to company practices and procedures.\nAssist in organizing the on-boarding and training of new hires to the team.\nPerform verification of services and charges and in some cases negotiate with providers contracted by Cigna or out-of-Network providers.\nRecommends changes in policy and procedures in order to mitigate risk and participates in projects to improve business protocols.\nProvides input into workforce planning and recruitment activities and addresses resource and operational challenges. \nProviding feedback to other departments in order to put in place safeguards to prevent further risk exposure\nWorking closely with other departments to ensure Payment Integrity activities do not have an unnecessary negative impact on our customers.\nSkills and Requirements:\nDemonstrated strong organization skills\nStrong attention to detail\nAbility to quickly learn new and complex tasks and concepts\nCompetent in processing or investigating claims on either the GlobalCare and or Actisure claim platforms\nMinimum of 2 years of health insurance or international health care provider experience.\nMinimum of 1 year of experience work in a Payment Integrity function preferred\nFluency in foreign languages in addition to fluent English is a strong plus\nKnowledge of medical terminology and treatment modalities is a plus.\nData analysis and reporting skills preferred\nInquisitive nature capable of thinking critically and challenging assumptions\nDemonstrated follow through on complex problems and tasks\nComfortable working independently and with a team\nFlexibility to work with global teams and varying time zones effectively.\nAbility to balance multiple priorities at once and deliver on tight timelines\nAbility to stay up to date on operations workflows\nAbility to develop and effectively communicate presentations and training materials\nStrong written and verbal communication skills\nPatience and creativity amongst your strong points\nProficiency with Microsoft Excel needed. Word, PowerPoint, Outlook, and SharePoint preferred\nExperience processing international claims preferred\nComfort with telephonic outreaches to global entities preferred\nAbout The Cigna Group\nCigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.","description_format":"text","description_chars":4657,"description_truncated":false,"requirements":{"experience_years_min":2,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[{"language":"English","level":"Advanced (C1)","optional":false}]},"benefits":["Health insurance"],"hiring_locations":[{"name":"Malaysia","iso":"MY","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Revenue Cycle & Medical Billing","Pharmacies","Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-09-25T11:18:13Z"}],"liveness":{"score":86,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":1,"age_days":0,"expected_fill_days":15,"reasons":["conf:0","win:early","comp:junior,brand"],"computed_at":"2026-09-26T00:45:20Z"},"pay":null,"html_url":"https://alion.io/job/the-cigna-group-payment-integrity-prepay-fraud-supervisor-cigna-healthcare","json_url":"https://alion.io/job/the-cigna-group-payment-integrity-prepay-fraud-supervisor-cigna-healthcare.json","meta":{"generated_at":"2026-09-26T00:45:20Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","usage":{"tier":"crawler","counted_by":"address","units_charged":1,"used_today":713,"day_limit":5000,"remaining_today":4287,"minute_limit":60,"resets_at":"2026-09-27T00:00:00Z"}}}