Medicare Quality Coding Review and Audit Manager

Are you passionate about ensuring the accuracy and integrity of healthcare data? Do you have experience in coding review and audits in the Medicare space? Cigna is seeking a skilled and dedicated Medicare Quality Coding Review and Audit Manager to join our team. In this role, you will play a critical role in maintaining the high quality of our coding and documentation practices, ensuring compliance with Medicare guidelines, and identifying potential areas for improvement. If you have a strong background in Medicare coding and auditing, excellent communication and leadership skills, and a commitment to delivering exceptional results, we want to hear from you. Join us in our mission to improve the health and well-being of our members and communities.

1. Develop and implement coding review and audit processes in accordance with Medicare guidelines and regulations.
2. Oversee a team of coding review and audit specialists, providing guidance and support to ensure efficient and accurate completion of audits.
3. Analyze data and reports to identify trends and areas for improvement in coding and documentation practices.
4. Collaborate with other departments, such as Compliance and Risk Management, to ensure adherence to Medicare guidelines and policies.
5. Communicate audit findings and recommendations to relevant stakeholders, including healthcare providers and internal teams.
6. Develop and maintain relationships with external partners, such as Medicare contractors and auditors.
7. Monitor and track audit results and provide regular reports to leadership on compliance and performance metrics.
8. Stay up-to-date on changes and updates to Medicare guidelines and regulations, and implement necessary changes to coding review and audit processes.
9. Conduct training and education sessions for coding and documentation best practices, as well as Medicare guidelines and regulations, for internal teams and external partners.
10. Ensure the security and confidentiality of all healthcare data and information in compliance with HIPAA regulations.

According to JobzMall, the average salary range for a Medicare Quality Coding Review and Audit Manager in Bloomfield, CT, USA is $90,000-$120,000 per year. This can vary depending on the specific job responsibilities, experience level, and employer.

Cigna Corp. provides medical, dental, disability, life and accident insurance and related products and services to businesses, governmental and non-governmental organizations and individuals. It operates through following segments: Global Health Care; Global Supplemental Benefits; Group Disability and Life; Other Operations; and Corporate.