The role of an Operations Analyst – Client Audit Coordinator responsible for managing external client audits, collaborating with cross-functional teams, analyzing audit results, and supporting overpayment recovery, requiring at least three years of claims processing experience and proficiency with the Proclaim system, with preferred qualifications including experience with additional processing platforms and virtual project leadership. **Responsibilities** + Manage external client audits from initiation through post-audit follow-up, ensuring timely, accurate completion and clear communication of audit status. + Research and respond to audit inquiries by leveraging KnowledgeXchange, internal partners, and deep claims processing expertise to provide clear, well-supported responses. + Collaborate with cross-functional partners including Enterprise Operations, Eligibility, Auto Adjudication, Quality, Client Audit Managers, and Client Service teams to resolve audit findings and outstanding claim issues. + Analyze audit results, identify root causes, and clearly articulate findings and improvement opportunities to senior leadership. + Maintain accurate audit documentation and tracking so leadership can quickly understand audit status, risks, and next steps. + Participate in reconciliation meetings to explain potential audit errors and support resolution efforts. + Provide regular updates to Client Audit Managers to support communication with internal and external partners. + Support overpayment recovery and claims adjustment reporting by partnering with internal teams and external vendors. + Contribute as a subject matter expert by supporting inquiry monitoring, reviewing audit responses, and participating in virtual projects, innovation releases, and team training sessions. + Work independently, take ownership of deliverables, and proactively manage competing priorities in a fast-paced environment. **Qualifications – Required** + High School Diploma or G.E.D. + 3+ years of claims processing experience. + 1+ years of experience using the Proclaim processing system. + Experience processing Level 2 claims or higher. + Strong auditing and analytical skills with the ability to assess claims accuracy and identify root causes. + Ability to manage multiple projects simultaneously while meeting external deadlines. + Strong written and verbal communication skills, including the ability to lead discussions with internal and external partners. + Demonstrated accountability, problem-solving skills, and ability to work independently and within a team. **Qualifications – Preferred** + Experience with additional processing platforms such as PMHS, Facets, or Cfunds. + Working knowledge of SAM3. + Experience leading or supporting virtual projects or training initiatives. + Bachelor’s degree or equivalent professional experience. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 23 - 35 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here (https://jobs.thecignagroup.com/us/en/benefits) . **About The Cigna Group** Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. _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._ _If you require reasonable accommodation in completing the online application process, please email:_ _SeeYourself@cigna.com_ _for support. Do not email_ _SeeYourself@cigna.com_ _for an update on your application or to provide your resume as you will not receive a response._ _The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._ _Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._