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CVS Health
CVS Health
MaloprodajaZdravstveno varstvoZdravstveno zavarovanje
CVS Health je ameriško zdravstveno podjetje, ki deluje na področju zdravstvenih storitev, zdravstvenega zavarovanja, upravljanja lekarniških ugodnosti in maloprodajnih lekarn. Prek podjetij, kot sta Aetna in CVS Caremark, podpira zdravstveno kritje, dostop do zdravil na recept, obvladovanje zdravstvenih stanj, specializirana zdravila in lekarniške storitve naročanja po pošti. Njegove lokalne lekarne in širša ponudba zdravstvene oskrbe so zasnovane tako, da ljudem omogočajo udobnejši in cenovno dostopnejši dostop do nujno potrebne zdravstvene oskrbe. CVS Health združuje zavarovanje, lekarniške in zdravstvene storitve ter tako podpira posameznike in skupnosti skozi celotno pot njihove zdravstvene oskrbe.
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Delovna mesta v podjetju

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.

USZdružene države AmerikeALAlabamaIDIdahoIAIowaKSKansasKYKentuckyLALouisianaMIMichiganMNMinnesotaMSMisisipiMOMisuriMTMontanaNJNew JerseyNMNova MehikaNCSeverna KarolinaNDSeverna DakotaOHOhioOKOklahomaPAPensilvanijaSCJužna KarolinaSDJužna DakotaTNTennesseeTXTeksasUTUtahVTVermontVAVirginijaWVZahodna VirginijaWIWisconsinWYWyoming
18 $ – 35 $ / ura
Na daljavoPolni delovni časJuniorZahtevani Jezik: angleščinaRevizor

Opis

  • 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.

Zahteve

  • 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.

Ugodnosti

  • 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.

Sorodna delovna mesta

CVS Health

Remote Medical Coding Quality Auditor at CVS Health

CVS Health
MaloprodajaZdravstveno varstvoZdravstveno zavarovanje
USZdružene države AmerikeALAlabamaAZArizonaCAKalifornijaCOKoloradoCTConnecticutFLFloridaIDIdahoILIllinoisIAIowaKSKansasKYKentuckyLALouisianaMEMaineMDMarylandMAMassachusettsMIMichiganMNMinnesotaMSMisisipiMOMisuriMTMontanaNENebraskaNVNevadaNHNew HampshireNJNew JerseyNMNova MehikaNYNew YorkNCSeverna KarolinaNDSeverna DakotaOHOhioOKOklahomaOROregonPAPensilvanijaRIRhode IslandSCJužna KarolinaSDJužna DakotaTNTennesseeTXTeksasUTUtahVTVermontVAVirginijaWAWashingtonWVZahodna VirginijaWIWisconsinWYWyoming
18 $ – 38 $ / ura
Na daljavoPolni delovni časJuniorZahtevani Jezik: angleščinaRevizor

Review medical records, validate ICD risk-adjustment diagnoses, and support compliance with CMS requirements at CVS Health. This U.S.-remote position calls for a coding certification and relevant medical-record auditing experience.

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Qlarant

Terenski revizor/preiskovalec II – preiskave USDA SNAP, delo na daljavo v ZDA

Qlarant
501 – 1000 Zaposleni
SvetovanjeZavarovanjeZdravstveno varstvo
USZdružene države AmerikeFLFloridaKYKentuckyMEMaineMDMarylandMAMassachusettsNJNew JerseyNYNew YorkOHOhioPAPensilvanijaTNTennessee
28 $ – 34 $ / ura
Na daljavoPolni delovni časJuniorSrednja ravenZahtevani Jezik: angleščinaRevizor

Qlarant išče terenskega revizorja/preiskovalca II za delo na daljavo pri preiskovanju goljufij, potratnosti in zlorab, povezanih s trgovci USDA SNAP. Delo vključuje zbiranje dokazov, razgovore z deležniki, analizo podatkov in pripravo preiskovalnih poročil.

Odpri