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Definitions

Table of Contents

• Overview
• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z

Overview

The purpose of this document is to provide new PBC employees with a list of definitions of common terminology and acronyms used by our client to help them get up to speed quickly. Hopefully, this can also be a helpful quick reference for older employees. Finer details of audit processes are discussed in other pages of this wiki.

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0-9

• 250K: A type of audit housed in SAM3. For details, read the 250K documentation.

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B

• BIA:

  1. Stands for "Business Intelligence Audit". A type of audit housed in CEM. For details, read the BIA documentation.
  2. A sample type in QUAD.

• BO: Stands for "Business Owner". Synonymous with "Customer Advocate".

• Buddy Group: A small group of people who share samples as a QA mechanism; the Quality Team assigned to a sample.

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C

• CA:

  1. Stands for "Customer Advocate"; synonymous with "Business Owner".
  2. Stands for "Client Audit", housed in SAM3 (see "Client Audit").

• CEM: Stands for "Customer Experience Management". A type of audit as well as the home of the QUAD audit.

• CDS: Stands for "Contract Document Service". A type of feed that QUAD pulls samples from.

• CDS Sampling: The process in which QUAD pulls samples from the Contract Document Service (CDS) feed.

• CGHB: Stands for "Cigna Global Health Benefits". A specialized Cigna segment for members staying overseas. Used in SAM3.

• Client Audit: A type of audit housed in SAM3.

• CP/CM: Stands for "Claim Processor" and "Claim Processor's Manager". Used in the SAM3 application, specifically in the NH OJT and 250K audits.

• CSE: Stands for "Client Service Executive". Part of the E2E/QUAD review process.

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D

• Drop Sampling: The process used to bulk-load intakes into our applications rather than manually entering them one by one. For more information read the Drop Sampling documentation.

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E

• E2E: Stands for "End to End". A workflow for auditing the full process of an account being setup (from one end to another) rather than a single piece of it. Audits that have been through QUAD that contain more sensitive information go through this workflow. For details, read the E2E documentation.

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G

• GSP: Stands for "Global Service Provider", i.e., contracted companies that Cigna uses to hire people offshore.

• GSP Management Intakes: Intake forms set up by GSP employees.

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I

• IM: Stands for "Implementation Manager". Used in SAM3 and E2E.

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O

• On-Base: A type of feed that QUAD pulls samples from.

• On-Base Sampling: The process in which QUAD pulls samples from the On-Base feed.

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N

• NH OJT: Stands for "New Hire on the Job Training". A type of audit housed in SAM3, similar in workflow to 250K.

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O

• OMD Team: Like a buddy group for claim processors and business owners. Called "production team" for processors and "subteam" for business owners. Processors are tied to the team by sam_OMD_CP, business owners are tied to the team by sam_OMD_CP_Platform.

P

• PG: Stands for "Performance Guaranty Audit". A type of audit housed in SAM3.

• Production Team: See "OMD Team".

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Q

• QM: Stands for "Quality Manager".

• QUAD: Stands for "Quality Audit Database". Software to allow the auditing of insurance plans to make sure they have been setup correctly. Housed in the CEM application.

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S

• SAM: Stands for "Smart Audit Master". A type of audit as well as the home of the ACClaim, NH OJT, 250K, CA, PG, and Measurement audits.

• Sample: A specific category that determines the type of audit to be performed.

• SOBI: Stands for "Service Operations Business Intelligence".

• SME: Stands for "Subject Matter Expert".

• Subteam: See "OMD team".

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