What are the responsibilities and job description for the Radiation Oncology - Clinical Auditor Analyst - eviCore - Remote position at Cigna?
Want to Drive Growth and Improve Lives? Do you have passion for purpose? EviCore, a division of The Cigna Group is hiring a Radiation Oncology - Clinical Auditor – Analyst. The Clinical Auditor is responsible for reviewing and auditing requests for approved Radiation Oncology treatment plans and procedures. This Auditor MUST be experienced in coding for Radiation Oncology Treatment procedures and be able to analyze information to determine the approved procedure codes and units. This Auditor will provide timely audit reviews for the medical necessity of services that have met utilization review criteria.
How you’ll make a difference:
Audit approved/partially approved authorizations.
Review approval letters for accuracy and request corrections as needed.
Review clinical documentation provided to support medical necessity.
Review patient medical history as necessary for new treatment course.
Document completed review to include changes made with units/codes from audit.
What you’ll need to be successful:
High school diploma or GED required
2 years of experience with Radiation Oncology procedures required
2 years of experience reviewing clinical documentation supporting medical necessity for Radiation Oncology procedures
Coding certification preferred, but not required
Tech savvy and proficient with Microsoft office products (Word, Outlook, Excel) required
What you’ll love about working here:
1st day benefits - Medical Dental & Vision and more
18 days Paid Time Off & 8 Paid Holidays
Caregiver leave
Annual Merit increases
Annual bonuses
Employer Contributions for HRA and HSA accounts
401K with Company Match
Tuition Assistance
Advancement opportunities
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 23 - 35 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
How you’ll make a difference:
Audit approved/partially approved authorizations.
Review approval letters for accuracy and request corrections as needed.
Review clinical documentation provided to support medical necessity.
Review patient medical history as necessary for new treatment course.
Document completed review to include changes made with units/codes from audit.
What you’ll need to be successful:
High school diploma or GED required
2 years of experience with Radiation Oncology procedures required
2 years of experience reviewing clinical documentation supporting medical necessity for Radiation Oncology procedures
Coding certification preferred, but not required
Tech savvy and proficient with Microsoft office products (Word, Outlook, Excel) required
What you’ll love about working here:
1st day benefits - Medical Dental & Vision and more
18 days Paid Time Off & 8 Paid Holidays
Caregiver leave
Annual Merit increases
Annual bonuses
Employer Contributions for HRA and HSA accounts
401K with Company Match
Tuition Assistance
Advancement opportunities
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.
For this position, we anticipate offering an hourly rate of 23 - 35 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
About Evernorth Health Services
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Salary : $23 - $35
Medical Director - EviCore
The Cigna Group -
Bloomfield, CT
Clinical Assistant - Oncology
Hartford Hospital -
Avon, CT
Manager, Auditor III - Remote
Health Services Advisory Group, Inc. -
Hartford, CT
