Current jobs related to Pharmacy Claims Auditor - Mississauga, Ontario - The Cigna Group
-
Pharmacy Claims Auditor
3 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionWe are seeking a highly skilled Pharmacy Claims Auditor to join our team at Cigna Health and Life Insurance Company. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
3 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionWe are seeking a highly skilled Pharmacy Claims Auditor to join our team at Cigna Health and Life Insurance Company. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
3 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionWe are seeking a highly skilled Pharmacy Claims Auditor to join our team at Cigna Health and Life Insurance Company. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
3 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionWe are seeking a highly skilled Pharmacy Claims Auditor to join our team at Cigna Health and Life Insurance Company. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionAt Cigna Health and Life Insurance Company, we are seeking a highly skilled Pharmacy Claims Auditor to join our team. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionAt Cigna Health and Life Insurance Company, we are seeking a highly skilled Pharmacy Claims Auditor to join our team. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers through diligent review and education. This position requires a strong analytical and investigative mindset, with the ability to analyze and problem-solve complex situations.Key...
-
Pharmacy Claims Auditor
3 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers through diligent review and education. This position requires a strong analytical and investigative mindset, with the ability to analyze and problem-solve complex situations.Key...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionAt Cigna Health and Life Insurance Company, we are seeking a highly skilled Pharmacy Claims Auditor to join our team. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada Cigna Health and Life Insurance Company Full timePharmacy Claims Auditor Job DescriptionAt Cigna Health and Life Insurance Company, we are seeking a highly skilled Pharmacy Claims Auditor to join our team. As a Pharmacy Claims Auditor, you will play a critical role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education.Key...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers. This position requires a strong analytical and investigative mindset, with the ability to identify trends and ensure compliance with benefit plan design and professional practice...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers. This position requires a strong analytical and investigative mindset, with the ability to identify trends and ensure compliance with benefit plan design and professional practice...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada Cigna Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers. This position involves conducting audits across Canada to validate that providers are compliant with benefit plan design and professional practice regulations.Key Responsibilities:Perform...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada Cigna Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers. This position involves conducting audits across Canada to validate that providers are compliant with benefit plan design and professional practice regulations.Key Responsibilities:Perform...
-
Pharmacy Claims Auditor
2 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a crucial role in ensuring the integrity of health claims and maintaining a network of providers through diligent review and education. This position requires strong analytical and investigative skills, as well as in-depth knowledge of pharmacy benefits, reimbursement, and pharmacy...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers through diligent review and education. This position requires a strong analytical and investigative mindset, as well as a deep understanding of pharmacy benefits, reimbursement, and...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers. This position requires a strong analytical and investigative mindset, with the ability to identify trends and ensure compliance with benefit plan design and professional practice...
-
Pharmacy Claims Auditor
4 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeJob Title: Pharmacy Claims AuditorThe Pharmacy Claims Auditor plays a critical role in ensuring the integrity of healthcare claims and maintaining a network of providers. This position requires a strong analytical and investigative mindset, with the ability to identify trends and ensure compliance with benefit plan design and professional practice...
-
Pharmacy Claims Auditor
1 week ago
Mississauga, Ontario, Canada The Cigna Group Full timeThe role of the Business Integrity team at The Cigna Group is to enhance the value proposition for customers by ensuring the integrity of health claims while maintaining a network of providers through diligent review and education. The Auditor is responsible for conducting various types of audits across Canada to validate that providers are compliant with...
-
Pharmacy Claims Auditor
2 weeks ago
Mississauga, Ontario, Canada The Cigna Group Full timeThe Pharmacy Claims Auditor role at The Cigna Group is a critical position that requires a strong analytical mindset and attention to detail. As a key member of our Business Integrity team, you will be responsible for conducting audits across Canada to ensure the integrity of health claims and maintain a network of providers.Key Responsibilities:Perform...
Pharmacy Claims Auditor
2 months ago
The Business Integrity team at The Cigna Group is seeking a highly skilled Pharmacy Claims Auditor to enhance the value proposition for customers and ensure the integrity of health claims. As a key member of the team, you will conduct audits across Canada to validate provider compliance with benefit plan design and professional practice regulations.
Key Responsibilities- Perform claim verifications, desk and/or on-site audits to ensure compliance with regulatory requirements.
- Communicate with providers to gather information, educate on claim submission practices, and respond to queries regarding audit results.
- Assess provider documentation to ensure compliance with The Cigna Group's provider agreement, benefit plan design, and provincial legislation.
- Calculate adjustments required to correct claim transactions and prepare audit reports that are detailed and unbiased.
- Track audit activity and summarize results of claim analysis and recoveries for department statistics.
- Identify trends observed from claim reviews and provide recommendations for risk criteria changes and/or candidates for a desk or on-site audit.
- 2-5 years recent retail pharmacy experience with working knowledge of pharmacy software.
- Valid driver's license and ability to travel in Canada (5-15% of time).
- Graduate of an accredited pharmacy education program; R Ph.T. designation is preferred.
- In-depth knowledge of pharmacy benefits, reimbursement, and pharmacy regulations.
- Previous audit/investigation experience.
- Ability to manage confidential information and work independently with minimal supervision.
- Strong critical thinking skills, effective time management, and organizational skills.
- Proficiency in MS Office (Excel, Word, Outlook) and bilingualism (French & English) is an asset.
The Cigna Group is a global health service company dedicated to improving the health, wellbeing, and peace of mind of those we serve. We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service, and alignment.
We are an equal opportunity employer that promotes a diverse, inclusive, and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.
