Quality Review & Audit Analyst

The Cigna Group

Quality Review & Audit Analyst evaluating complex medical conditions and compliance documentation at Cigna. Collaborating with team members to ensure data accuracy and suggest process improvements.

Posted 4/15/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-Level💰 $25 - $38 per hourWebsite

About the role

Key responsibilities & impact

Conduct medical records reviews with accurate diagnosis code abstraction
Utilize HHS’ Risk Adjustment Model to confirm accuracy of HCC
Apply longitudinal thinking to identify valid data elements
Perform various documentation and data audits
Collaborate and coordinate with team members and matrix partners
Coordinate with stakeholders to execute efficient RA programs
Communicate effectively across all audiences
Develop and implement internal program processes ensuring compliance with CMS/HHS

Requirements

What you’ll need

High school diploma
At least 2 years’ experience in medical documentation audits and medical chart reviews
Proficiency with ICD-10-CM coding guidelines and conventions
Familiarity with CMS regulations for Risk Adjustment programs
HCC coding experience preferred
Computer competency with Excel, MS Word, Adobe Acrobat
Detail oriented and self-motivated
Excellent organization skills
Understanding of medical claims submissions is preferred

Benefits

Comp & perks

Medical, vision, dental insurance
401(k)
Company paid life insurance
Tuition reimbursement
Minimum of 18 days of paid time off per year
Paid holidays

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

ICD-10-CM codingmedical documentation auditsmedical chart reviewsHCC codingdata auditsdiagnosis code abstractionRisk Adjustment Model

Soft Skills

detail orientedself-motivatedexcellent organization skillseffective communicationcollaborationcoordination