LogoFresh Jobs Ahead
CVS Health
CVS Health
MazumtirdzniecībaVeselības apdrošināšanaVeselības aprūpe
CVS Health ir Amerikas Savienoto Valstu veselības aprūpes uzņēmums, kas darbojas veselības aprūpes pakalpojumu, veselības apdrošināšanas, aptieku pabalstu pārvaldības un mazumtirdzniecības aptieku jomā. Ar tādiem uzņēmumiem kā Aetna un CVS Caremark tas atbalsta veselības apdrošināšanas segumu, recepšu medikamentu pieejamību, veselības stāvokļa pārvaldību, specializētus medikamentus un medikamentu pasūtīšanu pa pastu. Uzņēmuma apkārtnes aptiekas un plašāki aprūpes pakalpojumi ir veidoti, lai cilvēki varētu ērtāk un izdevīgāk saņemt būtiski nepieciešamo veselības aprūpi. CVS Health apvieno apdrošināšanu, aptieku un veselības aprūpes pakalpojumus, lai atbalstītu cilvēkus un kopienas visā viņu aprūpes ceļā.
LinkedIn
Vakances uzņēmumā

Senior Coding Quality Analyst, Special Investigations

Review coding quality for CVS Health’s Special Investigations Unit, assessing healthcare claims for accuracy and compliance. Identify potential billing errors, fraud, waste, abuse, and suspicious patterns.

USAmerikas Savienotās ValstisMNMinesota
46 988 $ – 102 000 $ / gads
HibrīdiPilna slodzeVecākais speciālistsNepieciešamā Valoda: angļuAnalītiķis

Apraksts

  • Review completed medical coding assessments for consistency with clinical records, CPT, HCPCS, and ICD-10 guidance, and payer, state, and federal rules.
  • Examine medical records tied to claims from medical, behavioral health, transportation, and other healthcare providers.
  • Assess data, records, and evidence for possible billing errors, abuse, fraud, and unusual billing patterns or trends.
  • Manage complex coding reviews related to legal and compliance matters, escalations, audits, and rework.
  • Document findings in detailed written reports and explain conclusions to leadership.
  • Research and apply state, CMS, and payer-specific rules to audits and reviews.
  • Spot opportunities to improve processes, reduce costs, and flag cases for prepayment review.
  • Keep documentation, records, files, and tracking logs accurate while meeting deadlines and performance targets.
  • Use departmental systems and workflows to support day-to-day operations.
  • Coach and train coders in quality, documentation standards, and review methods.
  • Step in for management and support team operations when the manager is absent.
  • Stay current on coding standards, compliance updates, reimbursement methods, and investigative practices.
  • Help improve investigative methods, tools, and processes.

Prasības

  • AAPC CPC certification.
  • At least one year reviewing coding consultant decisions for quality.
  • At least one year developing and implementing quality remediation plans.
  • At least one year of medical coding experience in a fraud, waste, abuse, or error department.
  • Knowledge of standard coding references and guidelines, including CPT, HCPCS, and ICD-10.
  • Experience researching coding rules and policies.
  • Experience with Microsoft products, including Excel and Word.
  • GED or high school diploma.
  • CPMA certification preferred.
  • Excellent communication skills preferred.
  • Excellent analytical skills preferred.
  • Strong attention to detail and ability to review and interpret data preferred.

Priekšrocības

  • Medical coverage.
  • Dental coverage.
  • Vision coverage.
  • Paid time off.
  • Retirement savings options.
  • Wellness programs.
  • Resources supporting physical, emotional, and financial well-being.
  • Eligibility for CVS Health bonus, commission, or short-term incentive programs.

Saistītās vakances

Crash Champions

General Manager, Collision Repair – Pompano Beach

Crash Champions
H1B vīzas sponsorsAutobūveElektroniskā komercijaRažošana
USAmerikas Savienotās ValstisFLFlorida
75 000 $ – 141 750 $ / gads
KlātienēPilna slodzeVidējais līmenisVecākais speciālistsNepieciešamā Valoda: angļuVadītājs

Lead daily collision repair operations at Crash Champions’ Pompano Beach center, overseeing production, staffing, repair quality, estimates, and performance goals. Support and develop the team while managing work from vehicle intake through delivery.

Atvērt
Harmoney

Integration Engineer – Java, REST and OpenAPI

Harmoney
51 – 200 Darbinieki
B2CFinansesFintech
BEBeļģija
3000 € – 5250 € / mēnesis
HibrīdiPilna slodzeVidējais līmenisVecākais speciālistsNepieciešamā Valoda: angļuNepieciešamā Valoda: holandiešuRisinājumu inženieris
AzureJavaKubernetes

Build and support Java-based integrations for Harmoney’s SaaS compliance platform, based from its Ghent office. Take ownership of the integration catalogue and help shape a future marketplace.

Atvērt
Carrier Commercial Refrigeration

Service Dispatcher, Technical Support — Carrier Commercial Refrigeration (Serbia, On-site)

Carrier Commercial Refrigeration
1001 – 5000 Darbinieki
LoģistikaPārtika un dzērieniVeselības aprūpe
RSSerbijaKlātienēPilna slodzeJaunākais speciālistsVidējais līmenisGrāds nav nepieciešamsNepieciešamā Valoda: angļuAtbalsta inženieris

Coordinate equipment service and technical support for Carrier Commercial Refrigeration customers in Serbia. The role combines on-site equipment work, customer inquiries, service documentation, troubleshooting, and escalation.

Atvērt