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CVS Health
CVS Health
Asigurare de sănătateAsistență medicalăComerț cu amănuntul
CVS Health este o companie americană din domeniul sănătății, care activează în servicii medicale, asigurări de sănătate, gestionarea beneficiilor farmaceutice și farmacii cu vânzare cu amănuntul. Prin companii precum Aetna și CVS Caremark, aceasta sprijină acoperirea medicală, accesul la medicamente eliberate pe bază de rețetă, gestionarea afecțiunilor, medicamentele specializate și serviciile de farmacie prin comenzi prin poștă. Farmaciile sale de proximitate și serviciile extinse de îngrijire sunt concepute pentru a-i ajuta pe oameni să acceseze mai ușor și mai accesibil servicii medicale esențiale. CVS Health reunește asigurările, farmacia și serviciile de sănătate pentru a sprijini persoanele și comunitățile pe tot parcursul experienței lor de îngrijire.
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Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiALAlabamaIDIdahoIAIowaKSKansasKYKentuckyLALouisianaMIMichiganMNMinnesotaMSMississippiMOMissouriMTMontanaNJNew JerseyNMNew MexicoNCCarolina de NordNDDakota de NordOHOhioOKOklahomaPAPennsylvaniaSCCarolina de SudSDDakota de SudTNTennesseeTXTexasUTUtahVTVermontVAVirginiaWVVirginia de VestWIWisconsinWYWyoming
18 $ – 35 $ / oră
RemoteNormă întreagăJuniorLimbă Obligatorie: englezăAuditor

Descriere

  • 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.

Cerințe

  • 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.

Beneficii

  • 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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Remote Medical Coding Quality Auditor at CVS Health

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USStatele Unite ale AmericiiALAlabamaAZArizonaCACaliforniaCOColoradoCTConnecticutFLFloridaIDIdahoILIllinoisIAIowaKSKansasKYKentuckyLALouisianaMEMaineMDMarylandMAMassachusettsMIMichiganMNMinnesotaMSMississippiMOMissouriMTMontanaNENebraskaNVNevadaNHNew HampshireNJNew JerseyNMNew MexicoNYNew YorkNCCarolina de NordNDDakota de NordOHOhioOKOklahomaOROregonPAPennsylvaniaRIRhode IslandSCCarolina de SudSDDakota de SudTNTennesseeTXTexasUTUtahVTVermontVAVirginiaWAWashingtonWVVirginia de VestWIWisconsinWYWyoming
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