POSITION SUMMARY

Conducts CPT and ICD-10 coding reviews by detailed examination of each line item in the physician medical record and charge session. Performs chart audits to ensure correct coding and charge capture have been applied appropriately. Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers.

ESSENTIAL FUNCTIONS

Reviews patient medical records and abstracts medical data that identifies all diagnoses and procedures. Codes diagnoses, procedures, and appropriate modifiers from the medical record documentation using ICD-10-CM, CPT4/HCPCS classification systems. Refers to a computerized encoding system, written coding aids and other reference materials to ensure accurate coding for billing.

• Sequences diagnoses, procedures and complications by following ICD-10-CM, CPT-4, guidelines. Adheres to the Official Guidelines for Coding and Reporting, Coding Clinic guidelines and other regulatory guidelines as appropriate.
  
  


• Maintains knowledge of coding and professional skills, including maintaining yearly coding credentials through attendance at in-service programs, conferences, workshops, review of current literature and other educational programs.
  
  


• Ensure billed service is being accurately coded.
  
  


• Addresses CCI and LCD edits within the various billing scrubbers while abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
  
  


• Reviews claim denials in comparison with medical records for the determination of accurate assignment of all documented diagnoses and procedures adhering to the standards of ethical coding.
  
  


• Reviews records for accuracy of scanned documents and reports any poorly scanned documents to management.
  
  


• Identifies misplaced or potentially litigious documentation and reports findings to management.
  
  


• Collaborates with other departments to ensure that record accurately reflects services provided and to identify documentation trends.
  
  


• Perform random chart/ SOAP audits.
  
  


• Provide continual coding updates.
  
  


• Research coding issues that arise.
  
  


• Codes diagnoses and procedures from the medical record using ICD-10-CM and CPT-4/HCPCS classification systems.
  
  


• Sequences diagnoses, procedures and complications by following ICD-10-CM, Medicare, Medicaid, and other fiscal intermediary guidelines.
  
  


• Performs other duties as needed.
  
  

QUALIFICATIONS

• High school degree or equivalent.
  
  


• Certified medical coder with one of the following certifications CPC,CPC-A, CPC-H or CPMA from AAPC or CCA, CCSP, CCS from AHIMA.
  
  


• ICD 10 knowledge.
  
  


• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
  
  


• 1-2 years experience required in a multi-specialty physician coding environment to include coding, compliance, and billing processes.
  
  

Knowledge and Skills:

• Work requires in-depth knowledge of medical terminology, ICD-10-CM and CPT-4 Work also requires basic concepts of human anatomy, physiology and pathology.
  
  


• Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
  
  


• Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
  
  


• Ability to work with accuracy and attention to detail.
  
  


• Ability to solve problems appropriately using job knowledge and current policies/procedures.
  
  


• Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests.
  
  


• Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.
  
  

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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.

Cigna 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.