Summary: The Quality Auditor performs internal audits for E/M Coding and validates Scoring Tool’s accuracy. The auditor records and reports result identifies issues trends and opportunities. Champion’s quality outcomes and purposeful well thought out change. - Duties and Responsibilities: E/M Scoring Tools - review verify & validate E/M Scoring tools. Detect issues propose improvements and guarantee tool accuracy. - Monitor tools performance in production environments. - Collaborate with cross-functional teams to address audit findings. Evaluates Tools for regulatory and ethical compliance. In depth audit of E/M Edit claim reviews. - Other Business Unit quality or focus audits if needed. Review and validate correct process and savings was followed and documented. Communicates audit result with end users in a professional manner. Record audit results and identify trends. - Recommend process improvements. - Functions as a Subject Matter Expert to matrix partners. Audit reviews for policy and compliance accuracy. - Performs other appropriate duties as assigned to meet the needs of the department. Must act as a change agent fostering independent thinking staff motivation/direction and the delivery of a quality product in a rapidly changing environment. - Qualifications Associate's Degree or higher strongly preferred or equivalent work experience required. 3+ years of medical coding experience required. One or more certifications required: Certified Coding Specialist (CCS) or Certified Profession Coder (CPC) (AAPC accredited preferred) or Certified Evaluation and Management Coder (CEMC). Experience in Quality Auditing a plus. Professional E&M Coding experience for professional billing and/or facility billing is required. Strong understanding of physiology medical terms and anatomy Proficiency in using digital tools such as coding software and patient record platforms. Payment integrity and claim review experience a plus. Knowledge of the Principles of Health Care Reimbursement. Experience in coding across multiple practices and remote coding experience is a plus. Extensive knowledge of Complex Claim Units processing standards policies and SOPs. Must be able to gather interpret produce and communicate progress opportunities and outcomes in both written and oral presentations. To excel in this role applicant should demonstrate great attention to detail. Excellent leadership skills. Knowledge of national trends state and federal mandates and compliance 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 annual salary of 67200 - 112000 USD / yearly depending on relevant factors including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy balanced and feel secure. That’s why 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) with company match company paid life insurance tuition reimbursement a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs visit Life at Cigna Group. About The Cigna Group Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. 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 require reasonable accommodation in completing the online application process please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. 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 manner consistent with all federal state and local ordinances.

Summary: The Quality Auditor performs internal audits for E/M Coding and validates Scoring Tool’s accuracy. The auditor records and reports result identifies issues trends and opportunities. Champion’s quality outcomes and purposeful well thought out change. - Duties and Responsibilities: E/M Scoring Tools - review verify & validate E/M Scoring tools. Detect issues propose improvements and guarantee tool accuracy. - Monitor tools performance in production environments. - Collaborate with cross-functional teams to address audit findings. Evaluates Tools for regulatory and ethical compliance. In depth audit of E/M Edit claim reviews. - Other Business Unit quality or focus audits if needed. Review and validate correct process and savings was followed and documented. Communicates audit result with end users in a professional manner. Record audit results and identify trends. - Recommend process improvements. - Functions as a Subject Matter Expert to matrix partners. Audit reviews for policy and compliance accuracy. - Performs other appropriate duties as assigned to meet the needs of the department. Must act as a change agent fostering independent thinking staff motivation/direction and the delivery of a quality product in a rapidly changing environment. - Qualifications Associate's Degree or higher strongly preferred or equivalent work experience required. 3+ years of medical coding experience required. One or more certifications required: Certified Coding Specialist (CCS) or Certified Profession Coder (CPC) (AAPC accredited preferred) or Certified Evaluation and Management Coder (CEMC). Experience in Quality Auditing a plus. Professional E&M Coding experience for professional billing and/or facility billing is required. Strong understanding of physiology medical terms and anatomy Proficiency in using digital tools such as coding software and patient record platforms. Payment integrity and claim review experience a plus. Knowledge of the Principles of Health Care Reimbursement. Experience in coding across multiple practices and remote coding experience is a plus. Extensive knowledge of Complex Claim Units processing standards policies and SOPs. Must be able to gather interpret produce and communicate progress opportunities and outcomes in both written and oral presentations. To excel in this role applicant should demonstrate great attention to detail. Excellent leadership skills. Knowledge of national trends state and federal mandates and compliance 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 annual salary of 67200 - 112000 USD / yearly depending on relevant factors including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy balanced and feel secure. That’s why 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) with company match company paid life insurance tuition reimbursement a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs visit Life at Cigna Group. About The Cigna Group Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. 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 require reasonable accommodation in completing the online application process please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response. 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 manner consistent with all federal state and local ordinances.

Fair Haven Community Health Care FHCHC is a forward-thinking dynamic and exciting community health center that provides care for multiple generations at over 143000 office visits in 21 locations. Overseen by a Board of Directors the majority of whom are patients themselves we are proud to offer a wide range of primary and specialty care services as well as evidence-based patient programs to educate patients in healthy lifestyle choices. As we grow and are able to bring high-quality health care to more areas that need access we continue to put our patients first in everything we do. The mission of FHCHC is “To improve the health and social well-being of the communities we serve through equitable high quality patient-centered care that is culturally responsive.” For 53 years we have been a health care leader in our community focused on providing excellent affordable primary care to all patients regardless of insurance status or ability to pay. Fair Haven is proud to have a motivated team of professionals who are constantly seeking ways to enhance and improve the health and well-being of all patients. We believe that everyone should have access to high-quality medical and dental care regardless of ability to pay. Job purpose Responsible for maintaining the professional reimbursement program. Ensure compliance with current payments and rules that impact billing and collection. Duties and responsibilities The Medical Billing Coder performs billing and computer functions including patient & third party billing data entry and posting encounters. Typical duties include but are not limited to: Follow-up of any outstanding A/R all-payers self-pay and the resolution of denials Prepares and submits clean claims to various insurance companies either electronically or by paper. Handle the follow-up of outstanding A/R all-payers including self-pay and /or the resolution of denials. Answers question from patients FHCHC staff and insurance companies. Identifies and resolves patient billing complaints. Prepares reviews and send patient statements and manage correspondence. Handle all correspondence related to insurance or patient account contacting insurance carriers patients and other facilities as needed to get the maximum payments and accounts and identify issues or changes to achieve client profitability. Take call from patients and insurance companies regarding billing and statement questions. Process and post all patient and/or insurance payments. Reviewing clinical documentation and provide coding support to clinical staff as needed. Qualifications High School diploma or GED with experience in medical billing is required. A certified professional coding certificate knowledge of third party billing requirements ICD and CPT codes and billing practices are also required. Excellent interpersonal and communication skills and ability to work as a member of the team to serve the patients is essential. Must be detail oriented and have the ability to work independently. Bi-lingual in English and Spanish highly preferred. FQHC/EPIC experience is desirable. Remote work disclosure: Based on organizational need FHCHC reserves the right to discontinue or revise remote work arrangements. FHCHC will provide advance notice to ensure a smooth transition to onsite reporting. American with Disabilities Requirements: External and internal applicants as well as position incumbents who become disabled must be able to perform the essential job specific functions (listed within each job specific responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis. Fair Haven Community Health Care is an Equal Opportunity Employer. FHCHC does not discriminate on the basis of race religion color sex gender identity sexual orientation age non-disqualifying physical or mental disability national origin veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications merit and business need. SLILSyoB1v