What are the responsibilities and job description for the Fraud Analyst – Payment Integrity position at The Cigna Group?
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Our people make all the difference in our success.
About Cigna
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
The job profile for this position is Fraud Analyst–Payment Integrity Global Investigation Unit, which is a Band 2 Senior Contributor Career Track Role.
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success.
Role Summary:
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 overpayment 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, 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 mind-set 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.
Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.