Individual & Family Plans (IFP) Quality Review & Audit Senior Supervisor - Remote - Cigna Healthcare

The Quality Review and Audit Senior Supervisor is responsible for day-to-day oversight of a team of Coding Analysts specializing in HHS Risk Adjustment medical record diagnostic coding and quality audit review for the Individual and Family Plan (IFP) segment, focusing on completion of time-bound objectives, ensuring accuracy, and leading projects to meet team goals.

Core Responsibilities:

• Leads team of certified coding professionals to accurately perform Risk Adjustment medical record reviews and audits, assigning appropriate ICD-10-CM diagnosis codes, and meeting workflow and compliance requirements.
• Monitors team quality, accuracy, and daily productivity standards, providing counseling and mentoring as required.
• Ensures all coding projects are performed in accordance with CMS’ Risk Adjustment program guidelines and adhere to all Official Code Set rules, and all Cigna guidelines and Best Practices for medical diagnosis code abstraction in support of the HHS Risk Adjustment program.
• Administers a quality review process for evaluation of individual team members work output.
• Supervises team prioritization and time management, adjusting assignments, as needed, to meet objectives.
• Generates curriculum and trains Coding Analysts in necessary tasks to execute on objectives, including use of coding application, workflows, Coding Best Practices, use of company assets, and other activities, as needed.
• Identifies areas of opportunity for process improvement and efficiency, communicating to leadership to facilitate operational effectiveness.
• Participates in development and review of coding guidelines, policies, and procedures to successfully execute the Cigna IFP Risk Adjustment program.

Minimum Qualifications:

• 5+ years coding experience with certification by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) in one of the following certifications, or comparable medical coding specialty: Certified Professional Coder (CPC), Certified Coding Specialist for Providers (CCS-P), Certified Coding Specialist for Hospitals (CCS-H), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA)
• Certified Risk Adjustment Coder (CRC) certification preferred (required within 12 months of hire)
• Proficiency with ICD-10-CM diagnostic coding guidelines
• Familiarity with CMS/HHS regulations preferred
• Inpatient coding knowledge preferred
• Basic knowledge of Microsoft Suite of products including Excel, Outlook, Adobe, and Word
• Ability to lead a team of professionals in successful execution of objectives
• Must be detail-oriented, self-motivated, and have excellent organizational skills
• Must possess professional oral and written communication skills
• Experience with HCC coding preferred
• Prior experience with working with EMR/EHR systems preferred but not required

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 annual salary of 70,100 - 116,800 USD / yearly, 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.

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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.