Senior Quality Review and Audit Analyst – RADV
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Quality Review and Audit Senior Analyst coordinating IFP Risk Adjustment processes. Liaising with audit entities to ensure compliance and audit success within Cigna's healthcare framework.
Responsibilities:
- Responsible for coordination and implementation of daily processes related to IFP Risk Adjustment programs
- Liaising with the Initial Validation Audit Entity to ensure compliant, efficient, and successful audit processes
- Coordinating with Quality Mgmt to effectively and compliantly execute daily RA program operations
- Participating in coding reviews of medical documentation for RA programs
- Communication and reporting of daily productivity and risks associated with IFP RADV audits
Requirements:
- High School Diploma
- 5+ year’s Risk Adjustment experience
- Certification by AHIMA or AAPC in CPC, CCS-P, CCS-H, RHIT, RHIA, or CRC
- Experience with medical audits
- Proficiency with ICD-10-CM coding and guidelines
- Familiarity with CMS regulations and policies related to documentation and coding
- HCC coding experience preferred
- Computer competency with Excel, MS Word, Adobe Acrobat
- Detail oriented, self-motivated, and excellent organization skills
Benefits:
- Health insurance
- Vision insurance
- Dental insurance
- Well-being and behavioral health programs
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
Similar Jobs
Epic Analyst III
Epic Analyst III responsible for design, build, and support of Epic Patient Access applications for DaVita. Collaborates with stakeholders to improve patient access workflows and system functionality.
Assistant Energy Analyst
Energy Analyst at GreenGen assisting clients in strategies to reduce energy consumption and greenhouse gas emissions. Collaborating on projects toward a sustainable energy future.
Virtual Real Estate Underwriter / Acquisitions Analyst
Underwriter coordinating real estate acquisitions for single-family and small multifamily properties. Operating independently to source and evaluate profitable investment opportunities.
ISO 27001 Analyst
ISO Analyst supporting audit and assurance teams in performing ISO 27001 certification assessments. Collaborating with auditors and assisting in the audit process for quality assurance.
ISO 27001 Analyst
ISO Analyst supporting ISO 27001 certification assessments and information security audits at Insight Assurance. This role requires strong attention to detail and effective communication skills.
Provider Enrollment Analyst, CMS 855 Required
Provider Enrollment Analyst at Broadway Ventures supporting medical provider enrollment and ensuring compliance. Responsibilities include reviewing applications, validating data, and assisting with process improvements.
Analista de IA – Pesquisador
Analyze AI technologies for smart condominiums project at Construtora Sudoeste. Requires 6 years experience or PhD in relevant fields.
Software Development Analyst II
Software Analyst developing financial solutions in a fintech focused on inclusion for Brazilian customers. Responsibilities include coding, architecture design, and agile ceremonies.
Senior Credit Analyst
Key role in shaping and executing RecargaPay’s credit strategy for Brazilian market. Responsible for data-driven decisions to ensure sustainable growth and improve customer experience.
IT Business Analyst
Analyst - IT Business at TDS Telecom focusing on stakeholder value through business analysis and process improvements. Collaborating with teams to ensure effective end-to-end solutions aligned with business goals.
401(k) Analyst – Temp to Hire
401(k) Analyst responsible for compliance and payroll processing for retirement plans at Natera. Ensuring regulatory adherence and guiding employees through enrollment and contributions.
Analista de Infraestrutura, Nível 2
Infrastructure Analyst responsible for configuring and optimizing technology infrastructure at 2com Consulting and clients. Ensuring security, stability, and operational efficiency in daily tasks.
Service Desk Analyst
Technical leader providing advanced technical support via phone, email, and chat for IT services. Collaborating with teams to troubleshoot complex issues and develop knowledge base documentation.
Observability Analyst, Elastic, Grafana
Implementing and managing Elastic Stack (ELK/EFK) for cyber security at It4us. Seeking a proficient analyst in Grafana and APM solutions.
HubSpot Analyst, Bilingüe
Managing HubSpot platform for RevOps team at Skydropx, optimizing marketing and sales processes. Supporting teams with training and data analysis in a multicultural environment.
Product Development Lead Analyst
Product Development Lead Analyst turning data into impactful solutions at Cigna Group. Leading product development initiatives and collaborating with cross-functional teams in healthcare.
Senior Delivery Analyst
Senior Delivery Analyst managing data product workflows and ensuring quality assurance at Acxiom. Responsible for coordinating with clients and stakeholders while leading projects on data processing.
Senior Analyst, Field Inventory Planning
Senior Analyst supporting field inventory planning at Petco, ensuring inventory readiness across new stores and promotional activities. Analyzing trends and collaborating with cross-functional teams.
IT Analyst – OpTime/Anesthesia
Epic IT Analyst managing application integrations and system configurations in healthcare setting for Baptist Health. Collaborating between IT and operations to ensure software aligns with goals and mandates.
Environmental Health SME – Solution Analyst
Solutions Analyst harnessing public health knowledge to enhance technology solutions for health departments. Collaborating to identify challenges and implementing efficient workflows.