Remote Audit Specialist II - Payer Compliance & QA

Cigna Healthcare; New York (NY); Remote; USD 37,000 - 55,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

Dental insurance

Well-being programs

401(k)

Life insurance

Tuition reimbursement

18 days paid time off per year

Paid holidays

Leaves of absence

Job summary

The Cigna Group is hiring an Audit Specialist II to facilitate audits within the approved program, review claim submissions, identify root causes, and resolve discrepancies. The role requires knowledge of home infusion, payer requirements, and strong communication skills.

You will prioritize tasks, conduct quality audits, assist in SOP development, and support training. This remote-friendly role offers potential annual bonus and a salary of 27–40 USD per hour, with comprehensive benefits.

Qualifications

• High School diploma or GED required.
• Proficiency in the Microsoft Office Suite.
• 3+ years of experience in home infusion revenue cycle.
• Strong knowledge of Federal and State billing guidelines.
• Working knowledge of basic medical terminology required.
• Excellent verbal and written communication skills.
• Strong customer service orientation.
• Excellent problem-solving skills.
• Strong interpersonal and organizational skills, with the ability to work on multiple tasks simultaneously with attention to detail.
• Experience with CPR+ Software.
• Experience with ICD-10, CPT-4, HCPCS, and Medicare billing is preferred.

Responsibilities

• Prioritize and complete all assigned tasks efficiently.
• Complete payer audits promptly before deadlines.
• Maintain knowledge of state and federal guidelines and payer requirements.
• Perform quarterly quality audit checks.
• Audit new employee performance until accuracy threshold is met.
• Conduct claim denial audits.
• Carry out ongoing quality focus audits on billing and collection activity.
• Assist with training on recurring errors found during audits.
• Assist in developing Standard Operating Procedures.
• Complete special projects as requested.
• Adhere to system-wide competencies and behaviors.

Skills

Verbal communication

Written communication

Customer service

Problem solving

Interpersonal skills

Organizational skills

Attention to detail

Microsoft Office

CPR+ Software

ICD-10/CPT-4/HCPCS/Medicare billing

Education

High School diploma or GED

Tools

CPR+ Software

Microsoft Office Suite

Job description

The Cigna Group is hiring an Audit Specialist II to facilitate audits within the approved program, review claim submissions, identify root causes, and resolve discrepancies. The role requires knowledge of home infusion, payer requirements, and strong communication skills.

You will prioritize tasks, conduct quality audits, assist in SOP development, and support training. This remote-friendly role offers potential annual bonus and a salary of 27–40 USD per hour, with comprehensive benefits.