Job opportunity
Healthcare Fraud Waste Abuse Auditor
Cigna Health and Life Insurance Company
Investigate healthcare claims within Express Scripts Canada’s Fraud, Waste, and Abuse department, working hybrid from Mississauga with Canadian travel. Analyze evidence and provider practices.
As an Extended Healthcare Claims Auditor, you will validate provider compliance with benefit plans and provincial regulations. The 12-month contract combines claim reviews, desk and on-site audits, investigative analysis, and provider education. Your findings will support accurate recoveries, customer reporting, and evolving risk-management techniques. Healthcare experience and pharmacy education are relevant foundations.
Key Responsibilities:
Conduct provider audits across Canada
Communicate audit results and claim submission practices
Review documentation for regulatory and plan compliance
Complete post-audit activities and unbiased reporting
Track analyses, recoveries, and department statistics
Requirements:
Two to five years recent healthcare experience
Graduate of accredited pharmacy education program
RPhT designation preferred; audit experience an asset
Ability to travel twenty to thirty percent
Strong communication, organization, and problem-solving skills
Support healthcare integrity through provider investigations, audit reporting, claim adjustments, and risk analysis for Express Scripts Canada.
#J-18808-Ljbffr
Apply on source site As an Extended Healthcare Claims Auditor, you will validate provider compliance with benefit plans and provincial regulations. The 12-month contract combines claim reviews, desk and on-site audits, investigative analysis, and provider education. Your findings will support accurate recoveries, customer reporting, and evolving risk-management techniques. Healthcare experience and pharmacy education are relevant foundations.
Key Responsibilities:
Conduct provider audits across Canada
Communicate audit results and claim submission practices
Review documentation for regulatory and plan compliance
Complete post-audit activities and unbiased reporting
Track analyses, recoveries, and department statistics
Requirements:
Two to five years recent healthcare experience
Graduate of accredited pharmacy education program
RPhT designation preferred; audit experience an asset
Ability to travel twenty to thirty percent
Strong communication, organization, and problem-solving skills
Support healthcare integrity through provider investigations, audit reporting, claim adjustments, and risk analysis for Express Scripts Canada.
#J-18808-Ljbffr