HCC Coding Education Lead Analyst - Cigna Healthcare - Hybrid (Alabama)
About the position
The HCC Coding Education Lead Analyst at Cigna Healthcare is responsible for supporting the Medicare Advantage Risk Adjustment program by ensuring accurate coding documentation among assigned provider groups. This role involves direct interaction with providers to achieve risk adjustment metrics, providing training and education on coding standards, and analyzing data to identify trends in diagnosis coding. The Lead Analyst will also mentor junior analysts and collaborate with various stakeholders to enhance coding practices and compliance with federal regulations.
Responsibilities
Support the training and development of Senior Analysts and Lead Representatives in partnership with the Risk Adjustment Manager.
,
Identify and influence the adoption of resources and processes to meet risk adjustment and quality goals for assigned provider groups.
,
Conduct thorough reviews of multi-year diagnosis coding for assigned populations.
,
Track, monitor, and report on key performance metrics for coding initiatives.
,
Ensure effective communication with provider offices in collaboration with matrix partners.
,
Review audit educational opportunities and provide necessary training to primary and specialty care providers.
,
Analyze data for trends in provider office diagnosis coding and implement education as needed.
,
Develop relationships with clinical providers and communicate coding guidelines effectively.
,
Conduct provider training on health plan coding initiatives and requirements of the Risk Adjustment program.
,
Perform chart reviews and assess provider performance through various training methods.
,
Assist with research and respond to inquiries from audit departments regarding compliance and coding issues.
,
Attend risk adjustment and quality provider meetings to provide updates and education.
Requirements
Coding certification required through AHIMA or AAPC (CPC, CRC, CCS-P, or RHIT).
,
5+ years of risk adjustment coding experience, with 3+ years in a national Medicare Advantage health plan preferred.
,
Strong public speaking and communication skills, with experience in delivering subject matter expertise to large audiences.
,
Experience in teaching/training others on correct coding guidelines.
,
Extensive knowledge of ICD-10-CM/outpatient and CPT coding principles and guidelines.
,
Excellent understanding of medical terminology, disease processes, anatomy, and physiology.
,
Working knowledge of CPT/Evaluation and Management guidelines and CMS Risk Adjustment and HCC Coding Process.
,
Strong computer skills, including MS Word, Excel, and PowerPoint.
,
Ability to travel within assigned areas for meetings, including overnight travel as needed.
Nice-to-haves
Experience in a leadership role or mentoring junior staff.
,
Familiarity with healthcare compliance and regulatory requirements.
,
Knowledge of additional coding certifications or specialties.
Benefits
Smoking cessation program
,
Health insurance
,
Flexible scheduling
,
Professional development opportunities
,
Paid holidays
Apply Now
The HCC Coding Education Lead Analyst at Cigna Healthcare is responsible for supporting the Medicare Advantage Risk Adjustment program by ensuring accurate coding documentation among assigned provider groups. This role involves direct interaction with providers to achieve risk adjustment metrics, providing training and education on coding standards, and analyzing data to identify trends in diagnosis coding. The Lead Analyst will also mentor junior analysts and collaborate with various stakeholders to enhance coding practices and compliance with federal regulations.
Responsibilities
Support the training and development of Senior Analysts and Lead Representatives in partnership with the Risk Adjustment Manager.
,
Identify and influence the adoption of resources and processes to meet risk adjustment and quality goals for assigned provider groups.
,
Conduct thorough reviews of multi-year diagnosis coding for assigned populations.
,
Track, monitor, and report on key performance metrics for coding initiatives.
,
Ensure effective communication with provider offices in collaboration with matrix partners.
,
Review audit educational opportunities and provide necessary training to primary and specialty care providers.
,
Analyze data for trends in provider office diagnosis coding and implement education as needed.
,
Develop relationships with clinical providers and communicate coding guidelines effectively.
,
Conduct provider training on health plan coding initiatives and requirements of the Risk Adjustment program.
,
Perform chart reviews and assess provider performance through various training methods.
,
Assist with research and respond to inquiries from audit departments regarding compliance and coding issues.
,
Attend risk adjustment and quality provider meetings to provide updates and education.
Requirements
Coding certification required through AHIMA or AAPC (CPC, CRC, CCS-P, or RHIT).
,
5+ years of risk adjustment coding experience, with 3+ years in a national Medicare Advantage health plan preferred.
,
Strong public speaking and communication skills, with experience in delivering subject matter expertise to large audiences.
,
Experience in teaching/training others on correct coding guidelines.
,
Extensive knowledge of ICD-10-CM/outpatient and CPT coding principles and guidelines.
,
Excellent understanding of medical terminology, disease processes, anatomy, and physiology.
,
Working knowledge of CPT/Evaluation and Management guidelines and CMS Risk Adjustment and HCC Coding Process.
,
Strong computer skills, including MS Word, Excel, and PowerPoint.
,
Ability to travel within assigned areas for meetings, including overnight travel as needed.
Nice-to-haves
Experience in a leadership role or mentoring junior staff.
,
Familiarity with healthcare compliance and regulatory requirements.
,
Knowledge of additional coding certifications or specialties.
Benefits
Smoking cessation program
,
Health insurance
,
Flexible scheduling
,
Professional development opportunities
,
Paid holidays
Apply Now