Medical Coder - Cigna Healthcare - Remote at The Cigna Group

, , United States -

Full Time

Start Date

Immediate

Expiry Date

19 Jan, 26

Salary

31.0

Posted On

21 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Coding, Evaluation & Management Coding, ICD Diagnoses, CPT, HCPCS, Modifiers, Quality Assurance, Auditing Tools, Communication Skills, Problem Solving, Professional Certification, Healthcare Industry Knowledge, Flexibility, Teamwork, Resource Management, Fraud Identification

Industry

Hospitals and Health Care

Description

The job profile for this position is Appeals Processing Lead Representative, which is a Band 2 Professional Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. POSITION SUMMARY The medical coder responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for Emergency Room encounters and office visits. Medical coder is responsible for making sure the assigned codes meet all federal, legal and insurance regulations. Primary Responsibilities Responsible for assignment of accurate Evaluation & Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for outpatient encounters. Work as part of a team and achieve the team quality and productivity standards Adheres to quality assurance standards Knows all changes in coding guidelines Uses auditing tools to monitor accuracy Handles escalated cases; assistance with problem solving and decision making Provides management of code updates, code updates, trends, concerns to ensure timely responses and actions Advises management of any concerns or complaints expressed by Health Care Professionals Utilizes effective communication, courtesy and professionalism in all interactions, both internally and externally Identify and refer cases for possible fraud/abuse or questionable billing practices to the appropriate matrix partners Handle multiple products and benefit plans Maintains active professional certification and complies with all educational, professional and ethical requirements of said certification Serves as resource and subject matter expert to other coding staff. Key Qualifications High school diploma or GED 3 years Medical Coding – Evaluation & Management (E/M) coding experience One or more certifications required: CPC, CPC-H, CCS, CCS-P Coding Certificate program (AAPC accredited preferred). Specialty certification with AAPC Certificated Evaluation & Management coder (CEMC) a plus. Proficient E/M Coding experience for both Pro-Fee & Facility charges. Knowledge of the US healthcare industry. Excellent computer and communication skills required. Flexible/Adaptable 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 - 31 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. 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. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Responsibilities

The medical coder is responsible for the assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, CPT, and HCPCS codes derived from medical record documentation for outpatient encounters. They must ensure that the assigned codes comply with all federal, legal, and insurance regulations.