HealthSpring, a Cigna company, is one of the country's leading health plans focused on delivering care to the senior population, predominately through Medicare Advantage and other Medicare and Medicaid products. Along with its companies Bravo Health and Leon Medical Centers Health Plans, HealthSpring serves more than one million customers in locations across the country. Based in Nashville, Tennessee, HealthSpring operates health plans in Alabama, Delaware, Florida, Georgia, Illinois, Maryland, Mississippi, New Jersey, Pennsylvania, Tennessee, Texas, West Virginia and Washington, D.C. HealthSpring also offers a national stand-alone prescription drug plan. For more information, visit www.cigna.com.
Provider Coding Specialist
The Provider Coding Specialist responsibilities may include the review of health management reports, remote chart reviews of electronic medical records for accuracy, in-house chart review of records retrieved from provider offices and extracting of data to identify coding opportunities. The specialist identifies provider training opportunities.
- Responsible for assigning ICD-9-CM codes to documentation received from provider offices.
- Reviews health management reports for coding accuracy, assign codes if missing, and document opportunities when applicable.
- May conduct remote chart reviews (extracting ICD-9-CM codes from medical records) or assign ICD-9-CM codes to documentation received for comprehensive review.
- Responsible for HMR and 360 physical results reporting. Identifies providers that may need additional education on ICD-9-CM coding, documentation requirements, or training on Company tools.
- May be responsible for scanning and indexing medical records as needed.
Minimum Requirements for the Provider Coding Specialist include:
At least one year of coding experience is required.
Some type of coding certification, which may include the following:
1 Certified Professional Coder (CPC)
2 Certified Coding Specialist for Providers (CCS-P)
3 Certified Coding Specialist for Hospitals (CCS-H)
4 Registered Health Information Technician (RHIT)
5 Registered Health Information Administrator (RHIA), or nursing medical background.
Additional requirements include:
Preferred Requirements: Bachelor’s degree. At least two years managed care experience.
- Extensive knowledge of ICD-9-CM, CPT, and CMS coding principles and guidelines.
- Familiarity with physician-specific regulations and polices related to documentation and coding.
- Knowledge of Medicare Risk Adjustment guidelines.
- Proficiency with ICD-9-CM coding and guidelines.
- Must be detail oriented, self motivated, and have excellent organization skills.
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