Quality Review and Audit Senior Representative (#36264688)
This position is a temporary assignment. As a contractor, you’ll be employed by Magnit, not The Cigna Group or any subsidiaries of The Cigna Group.
Quality Review & Audit Senior Representative Cigna IFP Risk Adjustment
Job Summary:
The position supports Cigna's Risk Adjustment program and is responsible for medical record chart retrieval and administration. This role is responsible for auditing, and problem-solving issues pertaining to retrieving and processing medical records.
Core Responsibilities:
● Monitors all chart retrieval activities for chart retrieval projects, and performs actions as defined by department workflows, including tracking outstanding records, analyzing barriers to retrieval, evaluating chart availability, reviewing for completeness & image quality, routing charts to the appropriate location, problem solving with retrieval vendors, and recording activities in the designated application.
● Performs outreach via telephone or secure fax to provider offices for requests including but not limited to additional information required, record delivery, retrieved record deficiencies, and signature deficiency attestation completion, as needed.
● Day to day quality audits on vendor chart records, responses, provider engagement, and related requirements.
● Ensures confidentiality and security of Cigna customer PPI/PHI by following all HIPAA, regulatory, and Cigna processes and release-of-information protocols.
● Follows Cigna medical records policies for storage and retention.
● Maintains a daily production tracker, or other reporting, in a predetermined format and cadence.
● Performs chart processing, vendor pend resolution, provider research, and other tasks as required to execute on Risk Adjustment programs.
Minimum
Qualifications:
● High School Diploma or equivalent
● Prior experience with working with EMR/EHR systems
● Knowledge of medical records, including basic medical terminology
● Strongly skilled in Microsoft Excel, Outlook management, Adobe and Word.
● Ability to manage time and tasks throughout your day efficiently in a virtual environment.
● Ability to determine when chart or site escalations are required to resolve issues.
● Ability to work as a team and individually on time-sensitive projects.
● Ability to perform work in an accurate and timely manner.
● Must be detail oriented, able to multi-task, accurate in data entry, able to follow directions, and apply criteria for multiple measures.
● General understanding of healthcare privacy regulations.
● Demonstrates clear, concise, and professional communications with peers and supervisors, in verbal, telephonic, and written communication.
● Demonstrates the ability to follow workflows independently as required.
● Prior experience with working with medical records preferred.
● Experience with HCC coding preferred but not required.
Hourly Pay Rate Range (dependent on location, experience, expectation)
The pay range that Magnit reasonably expects to pay for this position is: $23.00/hour-$27.00/hour
Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met)
Tundra Technical Solutions (the operator of this Talent Community) is a global leader of contingent talent services. Our success and our clients’ success are built on a foundation of service excellence. We are an equal opportunity employer, and we do not discriminate on the basis of race, religion, color, national origin, sex, sexual orientation, age, veteran status, disability, genetic information, or other applicable legally protected characteristic. Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law, including the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Unincorporated LA County workers: we reasonably believe that criminal history may have a direct, adverse and negative relationship with the following job duties, potentially resulting in the withdrawal of a conditional offer of employment: client provided property, including hardware (both of which may include data) entrusted to you from theft, loss or damage; return all portable client computer hardware in your possession (including the data contained therein) upon completion of the assignment, and; maintain the confidentiality of client proprietary, confidential, or non-public information. In addition, job duties require access to secure and protected client information technology systems and related data security obligations.
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.
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Quality Review & Audit Senior Representative Cigna IFP Risk Adjustment
Job Summary:
The position supports Cigna's Risk Adjustment program and is responsible for medical record chart retrieval and administration. This role is responsible for auditing, and problem-solving issues pertaining to retrieving and processing medical records.
Core Responsibilities:
● Monitors all chart retrieval activities for chart retrieval projects, and performs actions as defined by department workflows, including tracking outstanding records, analyzing barriers to retrieval, evaluating chart availability, reviewing for completeness & image quality, routing charts to the appropriate location, problem solving with retrieval vendors, and recording activities in the designated application.
● Performs outreach via telephone or secure fax to provider offices for requests including but not limited to additional information required, record delivery, retrieved record deficiencies, and signature deficiency attestation completion, as needed.
● Day to day quality audits on vendor chart records, responses, provider engagement, and related requirements.
● Ensures confidentiality and security of Cigna customer PPI/PHI by following all HIPAA, regulatory, and Cigna processes and release-of-information protocols.
● Follows Cigna medical records policies for storage and retention.
● Maintains a daily production tracker, or other reporting, in a predetermined format and cadence.
● Performs chart processing, vendor pend resolution, provider research, and other tasks as required to execute on Risk Adjustment programs.
Minimum
Qualifications:
● High School Diploma or equivalent
● Prior experience with working with EMR/EHR systems
● Knowledge of medical records, including basic medical terminology
● Strongly skilled in Microsoft Excel, Outlook management, Adobe and Word.
● Ability to manage time and tasks throughout your day efficiently in a virtual environment.
● Ability to determine when chart or site escalations are required to resolve issues.
● Ability to work as a team and individually on time-sensitive projects.
● Ability to perform work in an accurate and timely manner.
● Must be detail oriented, able to multi-task, accurate in data entry, able to follow directions, and apply criteria for multiple measures.
● General understanding of healthcare privacy regulations.
● Demonstrates clear, concise, and professional communications with peers and supervisors, in verbal, telephonic, and written communication.
● Demonstrates the ability to follow workflows independently as required.
● Prior experience with working with medical records preferred.
● Experience with HCC coding preferred but not required.
Hourly Pay Rate Range (dependent on location, experience, expectation)
The pay range that Magnit reasonably expects to pay for this position is: $23.00/hour-$27.00/hour
Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met)
Tundra Technical Solutions (the operator of this Talent Community) is a global leader of contingent talent services. Our success and our clients’ success are built on a foundation of service excellence. We are an equal opportunity employer, and we do not discriminate on the basis of race, religion, color, national origin, sex, sexual orientation, age, veteran status, disability, genetic information, or other applicable legally protected characteristic. Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law, including the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Unincorporated LA County workers: we reasonably believe that criminal history may have a direct, adverse and negative relationship with the following job duties, potentially resulting in the withdrawal of a conditional offer of employment: client provided property, including hardware (both of which may include data) entrusted to you from theft, loss or damage; return all portable client computer hardware in your possession (including the data contained therein) upon completion of the assignment, and; maintain the confidentiality of client proprietary, confidential, or non-public information. In addition, job duties require access to secure and protected client information technology systems and related data security obligations.
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.
Apply Now