CVS Health
CVS Health
CVS Health एक अमेरिकी स्वास्थ्य सेवा कंपनी है, जो स्वास्थ्य सेवाओं, स्वास्थ्य बीमा, फार्मेसी लाभ प्रबंधन और रिटेल फार्मेसी के क्षेत्रों में काम करती है। Aetna और CVS Caremark जैसे व्यवसायों के माध्यम से यह स्वास्थ्य कवरेज, दवाओं तक पहुंच, रोग प्रबंधन, विशेष दवाओं और मेल-ऑर्डर फार्मेसी सेवाओं में सहायता प्रदान करती है। इसकी स्थानीय फार्मेसियां और व्यापक स्वास्थ्य सेवाएं लोगों को आवश्यक स्वास्थ्य देखभाल अधिक सुविधाजनक और किफायती तरीके से प्राप्त करने में मदद करने के लिए बनाई गई हैं। CVS Health बीमा, फार्मेसी और स्वास्थ्य सेवाओं को एक साथ लाकर लोगों और समुदायों को उनकी स्वास्थ्य यात्रा के दौरान सहयोग प्रदान करती है।

Remote Data Quality Auditor, Medical Coding — CVS Health

Review medical records and ICD codes for CVS Health’s risk adjustment programs. Support accurate clinical documentation, coding, and regulatory compliance.

विवरण

  • Audit and abstract medical records received from providers and vendors.
  • Select and submit accurate, clinically supported ICD codes to CMS for risk adjustment.
  • Use industry-standard evidence and tools to support coding decisions.
  • Assign medical codes to diagnoses documented by physicians and other qualified providers in office or facility settings.
  • Apply coding rules and regulations, including medical necessity requirements.
  • Distinguish active clinical conditions from historical ones.
  • Verify medical record documentation for disease causes and manifestations.
  • Complete work within project deadlines and other specified timelines.
  • Audit personal processes for compliance with internal procedures and guidance from CMS, OIG, and other regulators.

आवश्यकताएँ

  • At least one year of recent, related experience reviewing medical record documentation, coding diagnoses, and/or conducting audits.
  • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) certification.
  • Computer skills, including Microsoft Office applications (Word, Excel, Access, PowerPoint, and Outlook) and standard coding software.
  • Experience using International Classification of Diseases (ICD) codes.
  • CRC (Certified Risk Adjustment Coder) certification preferred.
  • Experience with Medicare, commercial, and/or Medicaid risk adjustment processes and Hierarchical Condition Categories (HCC) preferred.
  • AA/AS degree or equivalent experience.
  • Completion of an AAPC or AHIMA training program for a core credential (CPC or CCS-P), with related work history or on-the-job experience totaling approximately one to two years for CPC.

लाभ

  • CVS Health bonus, commission, or short-term incentive program in addition to the base pay range.
  • Medical coverage.
  • Dental coverage.
  • Vision coverage.
  • Paid time off.
  • Retirement savings options.
  • Wellness programs.
  • Other resources for physical, emotional, and financial well-being, subject to eligibility.

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