Quality Review and Audit Senior Representative

3 weeks ago


Nashville, United States Cigna Full time
Job Description

This is a temporary role through PRO Unlimited with one of the world's leading health insurance companies.

Quality Review & Audit Senior Representative

Chart Administration & Interoperability

Job Summary:

The Quality Review & Audit Senior Representative supports Cigna's Individual and Family Plans (IFP) Risk Adjustment Chart Administration program under the direction of management through day-to-day chart retrieval, processing, and administrative tasks.

Core Responsibilities:
•Monitors all chart retrieval activities for IFP projects, and performs such actions as defined by department workflows, including tasks such as tracking outstanding records, evaluating chart availability, reviewing for completeness & image quality, routing charts to the appropriate location, problem-solving with retrieval vendors, and recording activities in the designated application.
•Performs outreach via telephone or secure fax to provider offices for requests including but not limited to additional information required, record delivery, retrieved record deficiencies, and signature deficiency attestation completion, as needed.
•Ensures confidentiality and security of Cigna customer PPI/PHI by following all HIPAA, regulatory, and Cigna processes and release-of-information protocols.
•Follows Cigna medical records policies for storage and retention.
•Maintains a daily production tracker in a predetermined format, submitting to Supervisor in a weekly cadence.
•Performs chart processing, vendor pend resolution, provider research, and other tasks as required to execute IFP Risk Adjustment programs.
•Demonstrates clear, concise, and professional communications with peers and supervisors, in verbal, telephonic, and written communication.

Minimum Qualifications:
•High School Diploma or equivalent
•Knowledge of medical records, including basic medical terminology
•Basic knowledge of Microsoft Excel, Outlook management, Adobe and Word
•Ability to work as a team and individually on time-sensitive projects.
•Must be detail oriented, able to multi-task, accurate in data entry, able to follow directions, and able to apply criteria for multiple measures.
•Skilled in use of basic office equipment (i.e., fax, photocopying equipment, printer, etc.)
•General understanding of healthcare privacy regulations is desirable; training will be provided.
•Candidate must possess a professional appearance, have good oral and written communication skills, be self-directed, and well-organized.
•Prior experience with working with medical records preferred.
•Prior experience with working with EMR/EHR systems is preferred but not required.
•Experience with HCC coding preferred but not required.

Top Skills:
•Knowledge of medical records, including basic medical terminology
•Basic knowledge of Microsoft Excel, Outlook management, Adobe and Word
•Ability to work as a team and individually on time-sensitive projects
•Must be detail-oriented, able to multi-task, accurate in data entry, follow directions, and apply criteria for multiple measures.

Location:
•Hybrid

Hourly Pay Rate Range (dependent on location, experience, and expectation)
•The pay range that Magnit reasonably expects to pay for this position is $18.11-24.14/hour.
•Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met)
  • Audit Senior

    7 days ago


    Nashville, United States Elliott Davis Full time

    WHO WE ARE Elliott Davis pairs forward-thinking tax, assurance and consulting services with industry-leading workplace culture. Our nine offices - located in the fastest growing cities in the US - are built on a foundation of inclusivity, collaboration, and collective growth. We work daily to provide exceptional service to our people, customers, and our...

  • Audit Senior

    1 week ago


    Nashville, United States Elliot Davis, DDS Full time

    WHO WE ARE Elliott Davis pairs forward-thinking tax, assurance and consulting services with industry-leading workplace culture. Our nine offices - located in the fastest growing cities in the US - are built on a foundation of inclusivity, collaboration, and collective growth. We work daily to provide exceptional service to our people, customers, and our...

  • Audit Senior

    4 weeks ago


    Nashville, United States ED01 Elliott Davis, LLC Full time

    Elliott Davis pairs forward-thinking tax, assurance and consulting services with industry-leading workplace culture. Our nine offices — located in the fastest growing cities in the US — are built on a foundation of inclusivity, collaboration, and collective growth. We work daily to provide exceptional service to our people, customers, and our...

  • Audit Senior

    2 weeks ago


    Nashville, United States UHY LLP Full time

    We are looking to add an Audit Senior to help lead and guide our clients, in addition to supporting our internal leaders with the on-going growth in our Midwest Region. As an Audit Senior, you will be responsible for performing and leading the necessary procedures involved in planning and executing attestation engagements for clients in accordance with the...

  • Internal Audit Senior

    2 weeks ago


    Nashville, United States Elliott Davis Full time

    Who We Are Elliott Davis pairs forward-thinking tax, assurance and consulting services with industry-leading workplace culture. Our nine offices located in the fastest growing cities in the US are built on a foundation of inclusivity, collaboration, and collective growth. We work daily to provide exceptional service to our people, customers, and our...


  • Nashville, United States Jenn Nguyen and Friends Full time

    Job DescriptionJob DescriptionJoin Parallon: Empowering Healthcare Excellence!Who Are We? HCA Parallon stands at the forefront of the healthcare industry, offering unrivaled revenue cycle services. We collaborate with over 650 hospitals and 2,400 physician practices nationwide. As a proud member of the HCA Healthcare family, consistently recognized as one of...


  • Nashville, United States LBMC Full time

    OPPORTUNITY This Audit Senior Accountant role is a great opportunity for anyone passionate about auditing and is looking to step into a highly visible role with sophisticated clients. You would be joining a progressive office in Nashville, Chattanooga, or Knoxville, receiving support from seasoned industry professionals in the market and offering...


  • Nashville, United States Frazier & Deeter Full time

    Join Frazier & Deeter and be a part of a rapidly growing Top 50 accounting & advisory firm that has been repeatedly named a Best Firm to Work For, a Best Firm for Women and a Pacesetter firm among U.S. accounting firms. With offices in Atlanta, Alpharetta, Charlotte, Las Vegas, London, Nashville, and Tampa, there is a spot for you! We serve clients of all...


  • Nashville, United States FORVIS, LLP Full time

    Audit Senior Manager Location: Nashville, TN, USA Apply Company Profile: At FORVIS, your career is designed with a purpose. We want our team members to thrive professionally and feel the impact their work yields when serving clients, industries, and local communities. This starts by empowering team members to design a career journey that leverages their...


  • Nashville, United States Vanderbilt University Full time

    Job Description The Director of Internal Audit is responsible for leading the internal audit function at Vanderbilt University (VU) and will work collaboratively as part of a co-sourced model. The Director role is an integral part of the university's collaborative effort to enhance internal audit capabilities and provide valuable insights to the institution....


  • Nashville, United States Dell Full time

    Internal Audit SOX Senior AdvisorWe’re a global business – a multi-billion-dollar corporation. To stay strong and secure, it’s vital to have a robust audit and risk assessment of our financial and operational practices. That’s where our Internal Audit professionals come in. Preparing independent audit plans, conducting internal reviews and...


  • NASHVILLE, United States Dell Full time

    Internal Audit SOX Senior AdvisorWe’re a global business – a multi-billion-dollar corporation. To stay strong and secure, it’s vital to have a robust audit and risk assessment of our financial and operational practices. That’s where our Internal Audit professionals come in. Preparing independent audit plans, conducting internal reviews and...


  • Nashville, United States KraftCPAs PLLC Full time

    Job DescriptionJob DescriptionAudit Senior Accountant - Hybrid OpportunityIn a city known for music, we've proudly marched to our own beat since 1958. And we're just warming up.KraftCPAs PLLC is proud to be a thriving business and a contributor to our community's continued growth, and along with our community we continue to evolve. We're now...


  • Nashville, United States KraftCPAs PLLC Full time

    Job DescriptionJob DescriptionAudit Senior Accountant - Hybrid OpportunityIn a city known for music, we've proudly marched to our own beat since 1958. And we're just warming up.KraftCPAs PLLC is proud to be a thriving business and a contributor to our community's continued growth, and along with our community we continue to evolve. We're now...

  • Audit Senior Manager

    1 month ago


    Nashville, United States FORVIS Full time

    Description & Requirements Our firm provides assurance services that go beyond the compliance function. Alongside the rest of our team, you will bring credibility to our client's financial picture, communicate information objectively and clearly, and provide insight to help clients improve their businesses.If relationships are important to you, and you...

  • Audit Senior Manager

    1 month ago


    Nashville, United States FORVIS Full time

    Description & Requirements Our firm provides assurance services that go beyond the compliance function. Alongside the rest of our team, you will bring credibility to our client's financial picture, communicate information objectively and clearly, and provide insight to help clients improve their businesses.If relationships are important to you, and you...


  • Nashville, United States FORVIS Full time

    Description & Requirements Our firm provides assurance services that go beyond the compliance function. Alongside the rest of our team, you will bring credibility to our client's financial picture, communicate information objectively and clearly, and provide insight to help clients improve their businesses.If relationships are important to you, and you...


  • Nashville, United States KRAFTCPAS Full time

    America's "Music City" is the new "It City" for a good reason: Business is booming, buildings are rising, Nashville is growing, and so are we. KraftCPAs PLLC is one of Tennessee's largest financial service firms with four locations, more than 200 employees, and innovative approaches to accounting, tax, audit, and specialized services. We take pride in our...

  • IT Audit Associate

    1 week ago


    Nashville, United States AllianceBernstein Full time

    Who You'll Work With:The IT Audit Associate is responsible for planning, performing, reporting, supervising, and following up on specific audit assignments designed to assess the adequacy and effectiveness of the information technology processing environment. This individual will perform these activities under the guidance of the IT Audit Director and...

  • Audit Director

    1 week ago


    Nashville, Tennessee, United States HCA Healthcare Full time

    Description Introduction Do you want to join an organization that invests in you as a Audit Manager - Pharmacist? At HCA, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years.Benefits At HCA, we want to ensure your needs are met. We offer eligible colleagues an...