Job summary
Job post source
This job is directly from Evernorth Health Services, part of The Cigna Group.
Job overview
The Clinical/Medical Coder role involves conducting outpatient post-service claims and appeals coverage determinations to ensure compliance with benefit plans and regulatory requirements, impacting the accuracy and efficiency of claims processing.
Responsibilities and impact
The Clinical Coder reviews and makes coverage determinations on retrospective outpatient claims and appeals, researches claims information, ensures compliance with state and federal mandates, documents findings, manages workload within timeliness metrics, and adheres to HIPAA and other regulatory standards.
Compensation and benefits
The position offers an hourly wage of $19-$29 depending on experience and location, eligibility for an annual bonus, comprehensive health benefits starting day one, 401(k) with company match, life insurance, tuition reimbursement, paid time off, and holidays.
Experience and skills
Candidates must have a high school diploma or GED, coding certification (CCS-P or CPC), preferably 1+ years coding experience, familiarity with CPT-4 and ICD coding, knowledge of state and federal regulations, and 2+ years in billing, claims, or health insurance; strong research, organizational, and independent work skills are required.
Work environment and culture
The company emphasizes health, balance, security, and inclusivity with a tobacco-free policy and support for reasonable accommodations, reflecting a supportive and diverse work environment.
Company information
Evernorth Health Services is part of The Cigna Group, focused on improving health and vitality through healthcare and health services divisions.
Job location and travel
This is a remote position requiring a reliable broadband or fiber optic internet connection with specified speeds.
Application process
Applicants are advised to apply online and may request reasonable accommodations via a specified email; resumes or application updates should not be sent to that email.
Unique job features
The role involves working remotely with a focus on compliance with multiple regulatory standards and offers a comprehensive benefits package from a major healthcare company.
Company overview
Evernorth Health Services is a leading health services company that offers a wide range of healthcare solutions, including pharmacy benefits management, care delivery, and health intelligence. They generate revenue through service contracts with employers, health plans, and government agencies, providing integrated health services aimed at improving patient outcomes and reducing costs. Formed as a subsidiary of Cigna Corporation in 2020, Evernorth leverages advanced analytics and technology to deliver personalized care and drive innovation in the healthcare industry.
How to land this job
Position your resume to highlight your coding certifications such as CCS-P or CPC, emphasizing your knowledge of CPT-4 and ICD-9/ICD-10 coding and familiarity with medical terminology, anatomy, and physiology.
Showcase your experience or ability to handle retrospective outpatient claims, appeals, and coverage determinations, making sure to mention any knowledge of state and federal regulations including HIPAA and PPACA.
Apply through multiple channels including Evernorth Health Services' corporate career site and LinkedIn to maximize your chances of being noticed for the Clinical/Medical Coder role.
Connect with current employees in the coding or claims department at Evernorth on LinkedIn; start conversations by asking about their experience working with retrospective claims or recent regulatory changes affecting coding practices.
Optimize your resume for ATS by incorporating keywords from the job description such as 'retrospective outpatient claims,' 'bundling reviews,' 'HIPAA,' 'PPACA,' 'CPT-4,' 'ICD-10,' and 'coverage determinations' to ensure your resume passes automated screenings.
Use Jennie Johnson's Power Apply feature to automate applying across multiple platforms, tailor your resume with the right keywords, and identify LinkedIn contacts to network with, freeing up your time to focus on interview preparation and skill enhancement.
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