Senior Quality Review and Audit Analyst – RADV
The Cigna Group
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $58,400 - $97,400 per year
Job Level
About the role
- Responsible for coordination and implementation of daily processes related to IFP Risk Adjustment programs
- Liaising with the Initial Validation Audit Entity to ensure compliant, efficient, and successful audit processes
- Coordinating with Quality Mgmt to effectively and compliantly execute daily RA program operations
- Participating in coding reviews of medical documentation for RA programs
- Communication and reporting of daily productivity and risks associated with IFP RADV audits
Requirements
- High School Diploma
- 5+ year’s Risk Adjustment experience
- Certification by AHIMA or AAPC in CPC, CCS-P, CCS-H, RHIT, RHIA, or CRC
- Experience with medical audits
- Proficiency with ICD-10-CM coding and guidelines
- Familiarity with CMS regulations and policies related to documentation and coding
- HCC coding experience preferred
- Computer competency with Excel, MS Word, Adobe Acrobat
- Detail oriented, self-motivated, and excellent organization skills
Benefits
- Health insurance
- Vision insurance
- Dental insurance
- Well-being and behavioral health programs
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Risk AdjustmentICD-10-CM codingHCC codingmedical audits
Soft Skills
detail orientedself-motivatedexcellent organization skills
Certifications
AHIMA certificationAAPC certificationCPCCCS-PCCS-HRHITRHIACRC