HCC Coding Auditor - Remote- Cigna Healthcare

• 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:

  • Coding certification required through AHIMA or AAPC (at least one of the below):
    • Certified Professional Coder (CPC)
    • 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

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 24 - 36 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.

We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, 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, visit Life at Cigna Group.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.