Risk Adjustment 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.

Minimum Qualifications:



* Must possess an active professional coding credential through AHIMA or AAPC (required).


* Minimum 2-5 active years of experience as a medical coder (required).


* Experience with HCC coding (required).


* Extensive knowledge of CMS guidance of Risk Adjustment & ICD-10 CM diagnosis guidelines (required).


* Extensive knowledge of medical terminology, anatomy and physiology (required).


* Knowledge of pathophysiology and pharmacology (preferred).


* Extensive knowledge of Medicare and HIPAA regulations and guidelines (required).


* Excellent written and oral communication skills (required)


* Basic proficiency in Excel (required).


* Knowledge of Microsoft Word & Outlook (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 hourly rate of 21 - 32 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 b...