Top 1281 Remote healthcare internal audit Jobs in Remote

Quality Review and Audit Analyst – Cigna Healthcare – Remote
The Cigna Group —Remote
- $25 - $38 an hour
- Online Application
- Remote
- Mid-level
- High school diploma or GED
- Organizational skills
- Paid holidays
- Health insurance
2d
Prior Authorization Specialist I - Patient Access Services
Boston Medical Center —Remote
- $25.42 - $30.97 an hour
- Full-time
- Remote
- Bilingual
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
3d
Healthcare Quality Management Specialist (Remote)
MRIoA —Remote
- Full-time
- Remote
- Microsoft Word
- Background check
- 5 years
- Paid holidays
- Health insurance
Quick Apply
Senior Consultant - Healthcare Compliance
BerryDunn —Remote
- $100,000 - $125,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
Healthcare Claims Quality Analyst
Integra Partners —Remote
- $24 an hour
- Full-time
- Remote
- Spanish
- English
- Mid-level
- Paid parental leave
- Paid holidays
Quick Apply
Prior Authorization Specialist - Per Diem
Boston Medical Center —Remote
- $25.42 - $30.97 an hour
- Part-time
- Remote
- Bilingual
- Microsoft Excel
- Microsoft Outlook
- Health insurance
- Dental insurance
3d
Clinical Study Data Reviewer
IUVO BIOSCIENCE OPERATIONS, LLC —Remote
- $60,000 - $74,000 a year
- Remote
- Computer literacy
- Writing skills
- HIPAA
Quick Apply
Medical Records Collector (Remote)
Molina Healthcare —Imperial, CA
- $20.34 - $30.39 an hour
- Full-time
- Remote
- Microsoft Excel
- Administrative experience
- Driver's License
- Health insurance
Pharmacy Claims Representative (remote)
Dragonfly Health —Arlington, TX
- From $22 an hour
- 12 hour shift
- Remote
- HIPAA
- Mid-level
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
Healthcare TPA Member Services Processing Analyst
General Dynamics Information Technology —Remote
- $55,250 - $74,750 a year
- HIPAA
- Mid-level
- Administrative experience
- Paid holidays
- 401(k) matching
Lead Compliance Specialist, Medicaid - Remote
EmblemHealth —New York, NY
- $77,760 - $149,040 a year
- Remote
- Microsoft Excel
- Microsoft Outlook
- 5 years
Accounting and Administrative Clerk - Healthcare Claims TPA
innermark TPA —Remote
- $22 - $25 an hour
- Full-time
- Remote
- Background check
- Microsoft Excel
- HIPAA
- Health insurance
- 401(k)
Quick Apply
Utilization Management Clinical Reviewer
CuraFi —Remote
- $140,000 - $160,000 a year
- Full-time
- RN License
- Senior level
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
Credentialing Specialist (Part-Time Temp to Perm)
TapestryHealth —Remote
- $50,000 - $55,000 a year
- Part-time
- Remote
- Microsoft Outlook
- HIPAA
- Mid-level
Quick Apply
Director, Quality & Process Improvement, HEDIS Audit
Centene —Remote
- $118,400 - $219,000 a year
- Full-time
- Remote
- Background check
- 6 years
- Bachelor's degree
- Paid holidays
- Health insurance
Program Management Senior Advisor - Cigna Healthcare - Remote
The Cigna Group —Remote
- $116,100 - $193,500 a year
- Online Application
- 7 years
- Bachelor's degree
- Product management
- Paid holidays
- Health insurance
13d
Healthcare Recruiter & Scheduling Coordinator
Providence In-home Care Service —Remote
- $25 - $35 an hour
- Remote
- Bilingual
- Google Workspace
- HIPAA
- Paid time off
- Paid orientation
Quick Apply
4d
Claims Auditor- Remote
American Health Plans —Franklin, TN
- Remote
- Mid-level
- 2 years
- Paid holidays
- Disability insurance
Quick Apply
Team Lead, Enrollment Quality Assurance
Thyme Care —Remote
- $80,000 a year
- Full-time
- Remote
- 5 years
- Mid-level
- Supervising experience
Quick Apply
Revenue Cycle Specialist
Healthcare Retroactive Audits, Inc —Remote
- $49,385.72 - $59,475.27 a year
- Full-time
- Remote
- Background check
- HIPAA
- Research
- 401(k)
Quick Apply
5d

I want to receive the latest job alert for remote healthcare internal audit in remote

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

remote healthcare internal audit jobs near remote

Quality Review and Audit Analyst – Cigna Healthcare – Remote

The Cigna Group -
Remote

Apply Now

Job Details

Full-time
$25 - $38 an hour
2 days ago

Benefits

Paid holidays
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Smoking cessation program
Vision insurance
Life insurance

Qualifications

CMS
Medical coding experience in outpatient clinics
High school diploma or GED
CMS regulatory compliance
Medicare regulations
Centers for Medicare & Medicaid Services (CMS) billing regulations
Document viewing software
Clinical documentation standards
Adobe Acrobat
Documentation reviews

Full Job Description

The Risk Adjustment Quality Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex medical conditions, determines compliance of medical documentation, identifies trends, and suggests improvements in data and processes for Continuous Quality Improvement (CQI).

Duties Responsibilities

Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, Cigna IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set.
Utilize HHS’ Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC) identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year.
Apply longitudinal thinking to identify all valid and appropriate data elements and opportunities for data capture, through the lens of HHS’ Risk Adjustment.
Perform various documentation and data audits with identification of gaps and/or inaccuracies in risk adjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submission program. Inclusive of Quality Audits for vendor coding partners.
Collaborate and coordinate with team members and matrix partners to facilitate various aspects of coding and Risk Adjustment education with internal and external partners.
Coordinate with stake holders to execute efficient and compliant RA programs, raising any identified risks or program gaps to management in a timely manner.
Communicate effectively across all audiences (verbal written).
Develop and implement internal program processes ensuring CMS/HHS compliant programs, including contributing to Cigna IFP Coding Guideline updates and policy determinations, as needed.

Qualifications

High school diploma
2 years’ experience in one of the following Coding Certifications by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC):
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
Individuals who have a certification other than the CRC must become CRC certified within 6 months of hire.
Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding guidelines and conventions
Familiarity with CMS regulations for Risk Adjustment programs and policies related to documentation and coding compliance, with both Inpatient and Outpatient documentation
HCC coding experience preferred
Computer competency with excel, MS Word, Adobe Acrobat
Must be detail oriented, self-motivated, and have excellent organization skills
Understanding of medical claims submissions is preferred
Ability to meet timeline, productivity, and accuracy standards

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 25 - 38 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs,click here.

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

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.

If you need a reasonable accommodation to complete the online application process, please emailseeyourselfthecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a mannerconsistent with all federal, state and local ordinances.

Apply Now

Refine Your Search

remote healthcare internal audit jobs in remote

Quality Review and Audit Analyst – Cigna Healthcare – Remote

Prior Authorization Specialist I - Patient Access Services

Healthcare Quality Management Specialist (Remote)

Senior Consultant - Healthcare Compliance

Healthcare Claims Quality Analyst

Prior Authorization Specialist - Per Diem

Clinical Study Data Reviewer

Medical Records Collector (Remote)

Pharmacy Claims Representative (remote)

Healthcare TPA Member Services Processing Analyst

Lead Compliance Specialist, Medicaid - Remote

Accounting and Administrative Clerk - Healthcare Claims TPA

Utilization Management Clinical Reviewer

Credentialing Specialist (Part-Time Temp to Perm)

Director, Quality & Process Improvement, HEDIS Audit

Program Management Senior Advisor - Cigna Healthcare - Remote

Healthcare Recruiter & Scheduling Coordinator

Claims Auditor- Remote

Team Lead, Enrollment Quality Assurance

Revenue Cycle Specialist

I want to receive the latest job alert for remote healthcare internal audit in remote

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected