Cigna Medical Records Coder (Phoenix, AZ) in Phoenix, Arizona
This position performs complex professional coding in support of specialty or multi-specialty physician practices by evaluating medical records and validating that appropriate clinical diagnosis and procedure codes are assigned in accordance with nationally recognized coding guidelines.
- Reviews and analyzes diagnosis and procedure documentation from medical records against billed procedures to ensure accurate coding of specialty diagnoses and procedures in accordance with national coding guidelines and appropriate reimbursement requirements. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance.
- Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate review of ICD and/or CPT code assignments.
- Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards.
- Acts as a coding resource to clinical staff for billing and coding issues.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
NOTE: The essential functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.
- High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field.
- Must demonstrate a knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) coding competencies, and as required for the assigned practice areas. Requires 2-3 years or more of professional coding experience for clinical areas. Must be able to achieve an acceptable accuracy rate on any coding test that may be administered by the hiring business unit according to pre-established company standards. Requires the ability to work autonomously while maintaining a high level of accountability and quality performance outcomes. Must demonstrate excellent critical thinking and organization skills. Requires attention to detail.
- Must be able to work effectively with common office software, coding software, and abstracting systems.
- Medical Coding Credential from the American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA). Specialty coding certification a plus.
- Additional related education and/or experience preferred.
Primary Location: Phoenix-Arizona
Work Locations: 25500 N Norterra Drive, Bldg B Phoenix 85085
Job: Clinical--Allied Health
Employee Status: Individual Contributor
Job Type: Full-time
Job Level: Day Job
Job Posting: Nov 8, 2018, 8:48:00 AM
Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com