HCC Coding Auditor - Remote- Cigna Healthcare
The Cigna GroupUnited States Work at Home30+ days ago
Job type
- Full-time
- Remote
Job descriptionCoding certification required through AHIMA or AAPC (at least one of the below) : Certified Risk Adjustment Coder (CRC) Certified Coding Specialist for Providers (CCS-P) Registered Health Information Management Technician (RHIT) 2+ years of risk adjustment coding experience Extensive knowledge and adherence to ICD-10-CM principles and guidelines; AHA coding clinic knowledge Excellent understanding of medical terminology, disease process, anatomy, and physiology. Working Knowledge of CMS Risk Adjustment and HCC Coding Process. Strong computer skills (i.e., MS Word, Excel, PowerPoint) Ensure Compliance with HIPPA regulations and requirements. Ability to be flexible in work environment. Regularly and consistently achieve over 95% quality accuracy. Proven ability to support coding judgment and decision making Preferred experience in regulatory audit operations
Core Responsibilities :
Performs monitoring of Cigna Medicare coders & vendors in order to ensure quality metrics are achieved.
- Researches IRR disagreements with the purpose of providing substantive feedback to coders.
- Meets fluctuating production demands in order to reach sampling targets.
- Maintains a high level of quality, as set by internal standards, to ensure continued auditor accuracy.
- Stays up-to-date with current Cigna Medicare coding guidelines.
- Maintains coding credentials & CEUs.
- Proficiently functions in a virtual collaborative environment.
- Participates in regular team and company meetings.
- Other related duties as assigned.
Minimum Qualifications :
Certified Professional Coder (CPC)
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Coding Auditor • United States Work at Home