Individual & Family Plans (IFP) Quality Review & Audit Senior Supervisor - Remote - Cigna Healthcare

The Quality Review and Audit Senior Supervisor is responsible for day-to-day oversight of a team of Coding Analysts specializing in HHS Risk Adjustment medical record diagnostic coding and quality audit review for the Individual and Family Plan (IFP) segment, focusing on completion of time-bound objectives, ensuring accuracy, and leading projects to meet team goals.

Core Responsibilities:


* Leads team of certified coding professionals to accurately perform Risk Adjustment medical record reviews and audits, assigning appropriate ICD-10-CM diagnosis codes, and meeting workflow and compliance requirements.


* Monitors team quality, accuracy, and daily productivity standards, providing counseling and mentoring as required.


* Ensures all coding projects are performed in accordance with CMS' Risk Adjustment program guidelines and adhere to all Official Code Set rules, and all Cigna guidelines and Best Practices for medical diagnosis code abstraction in support of the HHS Risk Adjustment program.


* Administers a quality review process for evaluation of individual team members work output.


* Supervises team prioritization and time management, adjusting assignments, as needed, to meet objectives.


* Generates curriculum and trains Coding Analysts in necessary tasks to execute on objectives, including use of coding application, workflows, Coding Best Practices, use of company assets, and other activities, as needed.


* Identifies areas of opportunity for process improvement and efficiency, communicating to leadership to facilitate operational effectiveness.


* Participates in development and review of coding guidelines, policies, and procedures to successfully execute the Cigna IFP Risk Adjustment program.

Minimum Qualifications:


* 5+ years coding experience with certification by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) in one of the following certifications, or comparable medical coding specialty:
+ Certified Professional Coder (CPC)
+ Certified Coding Specialist for Providers (CCS-P)
+ Certified Coding Specialist for Hospitals (CCS-H)
+ Registered Health Information Technician (RHIT)
+ Registered Health Information Administrator (RHIA)



* Certified Risk Adjustment Coder (CRC) certification required


* Proficiency with ICD-10-CM diagnostic coding guidelines


* Familiarity with CMS/HHS regulations preferred


* Inpatient coding knowledge preferred


* Basic knowledge of Microsoft Suite of products including Excel, Outlook, Adobe, and Word


* Ability to lead a team of professionals in successful execution of objectives


* Must be detail-oriented, self-motivated, and have excellent organizational skills


* Must possess professional oral and written communication skills


* Experience with HCC coding preferred


* Prior experience with working wit...