Cigna Phoenix , AZ 85002
Provider Services Analyst - (16000899) -
To assist in the daily operations for developing and managing the Independent Provider Network, that includes educating, servicing, and training health care professionals in the accuracy of medical record documentation and code capture. To ensure understanding of policies and procedures and to work with partners to support effective communication with contracted healthcare professionals. Experience in provider relations is needed.
360 (physical exam) Documentation and Training
Proactive follow-up for non-compliant 360s and re-education
Daily support of physician/staff for coding and documentation questions pertaining to Medicare Advantage and Risk Adjustment
Formal training and education pertaining to Medicare Advantage and Risk Adjustment
Utilization of reporting and other tools to identify HCC capture opportunities
Assist CMCRs with retrospective audits when necessary
RADV/OIG audits when required
Collaborate with Network Operations
Accepts the need for change and willingly adjusts to new work processes.
Ability to positively handle challenges and diverse approaches to work and develops solutions to problems.
Looks for opportunities for process improvement and reports that information to appropriate person.
Enhance Customer Service
Demonstrates a commitment to excellent customer service at all times.
Treats customers with dignity/respect.
Maintains patient confidentiality.
US Candidates Only: Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. If you require a special accommodation, please visit our Careers website or contact us at
High school diploma required with college preferred.
Strong knowledge in medical terminology, anatomy and physiology, ICD-9/ICD-10 and CPT-4 coding with 2 or more years of working knowledge required.
Experience with HCC coding strongly preferred.
Medical records auditing experience preferred.
CPC or CCS P certification required
Good verbal and written communication skills required.
Strong internal and external customer service skills.
Microsoft skills required in both Word and Excel.