Coding Education Specialist

Employer
Cigna
Location
Baltimore, MD
Posted
Sep 10, 2022
Closes
Sep 25, 2022
Ref
646580042
Function
Accountant, IT
Industry
Healthcare
Hours
Full Time
P What you must have in order to do the job: Remote, Work from Home - must be located in Baltimore Coding certification required (at least one of the below): Certified Professional Coder (CPC) Certified Risk Adjustment Coder (CRC)Certified Coding Specialist for Providers (CCS-P)Certified Coding Specialist for Hospitals (CCS-H)Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA)At least two years' of hospital inpatient / outpatient or medical office coding experience, preferably two years risk adjustment coding experience.Extensive knowledge and adherence to ICD-10-CM/outpatient and CPT coding principles and guidelines. Excellent understanding of medical terminology, disease process and anatomy and physiology. Working knowledge of CPT/Evaluation and Management guidelines, Working Knowledge of CMS Risk Adjustment and HCC Coding Process, Strong computer skills (ie MS Office). Prior audit/quality experience. Prior experiences teaching/training others on correct coding guidelines and/or have the ability to present to large groups of Physicians/Providers. Minimal travel may be required for this position and person needs to be available for occasional day, evening and weekend training sessions. Core Responsibilities: Develop relationships with clinical providers/staff and communicate coding and documentationConduct provider training on health plan coding initiatives guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentationCustomize presentations to educate providers and staff.Understands, develops, tracks, monitors and reports on key program performance metrics for coding initiativeConduct chart reviews for providers and review provider performance.T his is accomplished by doing virtual training sessions or traveling to the individual practices and performing side-by-side education.Work closely with internal representative for needs and supportEvaluate documentation to ensure that diagnosis coding is supported and meets specificity requirement to support clinical indicators, HEDIS and STARS quality measuresQuery providers regarding missing, unclear or conflicting health record documentation by requesting and obtaining additional documentation within the heath recordAnalyze data to prioritize provider educational reviews. Implement education, where necessary, and provide formal training to providers and staff regarding coding and documentation standardsParticipate in monthly Quality reviewsAssist, as needed, to meet departmental goals/deadlines Rely upon independent judgment and decision-making at provider sites, whether conducting chart review or providing training/education, both for historical and/or real time dataAssists with research, analysis and response to inquiries regarding compliance, coding, and inappropriate codingCompile data and present solutions regarding trends or patterns noticed in provider codingPerform the minimum number of coding quality reviews consistent with established departmental goalsTake direction and guidance from Coding Supervisor and the Clinical Program Manager of the Coding DepartmentMaintain a 95% quality audit accuracy rateMaintain strictest confidentiality based on HIPAA privacy policy Maintain current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10 CM, CPT, HCPCSCapacity to attend provider meetings day/evening/weekends as needed within assigned areas Minimum Requirements: - Coding certification through AHIMA or AAPC, which may include Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC) Certified Coding Specialist for Providers (CCS-P), Certified Coding Specialist for Hospitals (CCS-H), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), required.- At least two years' of hospital inpatient / outpatient or medical office coding experience, preferably two years risk adjustment coding experience required.- Extensive knowledge and adherence to ICD-10-CM/outpatient and CPT coding principles and guidelines.- Excellent understanding of medical terminology, disease process and anatomy and physiology.- Working knowledge of CPT/Evaluation and Management guidelines, Working Knowledge of CMS Risk Adjustment and HCC Coding Process- Strong computer skills (ie MS Word, Excel, PowerPoint).- Prior audit/quality experience required. - Prior experiences teaching/training others on correct coding guidelines and/or have the ability to present to large groups of Physicians/Providers. lease see attachedAbout CignaCigna 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.

Similar jobs