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CVS Health
CVS Health
Chakana savdoSog‘liqni saqlashTibbiy sug‘urta
CVS Health sog‘liqni saqlash xizmatlari, tibbiy sug‘urta, dorixona imtiyozlarini boshqarish va chakana dorixona faoliyati yo‘nalishlarida ishlaydigan Amerika kompaniyasidir. Aetna va CVS Caremark kabi bizneslari orqali tibbiy sug‘urta qamrovi, retsept bo‘yicha dori vositalaridan foydalanish, kasalliklarni boshqarish, maxsus dori-darmonlar va pochta orqali dorixona xizmatlarini taqdim etadi. Uning mahalliy dorixonalari va keng qamrovli tibbiy xizmatlari odamlarga zarur tibbiy yordamdan qulayroq va hamyonboproq foydalanishga yordam berish uchun mo‘ljallangan. CVS Health sug‘urta, dorixona va sog‘liqni saqlash xizmatlarini birlashtirib, insonlar va jamoalarni davolanish jarayonining barcha bosqichlarida qo‘llab-quvvatlaydi.
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Kompaniyadagi ish o‘rinlari

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.

USAmerika Qo‘shma ShtatlariALAlabamaIDAydahoIAAyovaKSKanzasKYKentukkiLALuizianaMIMichiganMNMinnesotaMSMissisipiMOMissuriMTMontanaNJNyu-JersiNMNyu-MeksikoNCShimoliy KarolinaNDShimoliy DakotaOHOgayoOKOklaxomaPAPensilvaniyaSCJanubiy KarolinaSDJanubiy DakotaTNTennessiTXTexasUTYutaVTVermontVAVirjiniyaWVG‘arbiy VirjiniyaWIViskonsinWYVayoming
18 $ – 35 $ / soat
MasofaviyTo‘liq stavkaJuniorTalab Qilinadigan Til: inglizchaAuditor

Tavsif

  • 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.

Talablar

  • 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.

Imtiyozlar

  • 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.

O‘xshash ish o‘rinlari

CVS Health

Remote Medical Coding Quality Auditor at CVS Health

CVS Health
Chakana savdoSog‘liqni saqlashTibbiy sug‘urta
USAmerika Qo‘shma ShtatlariALAlabamaAZArizonaCAKaliforniyaCOKoloradoCTKonnektikutFLFloridaIDAydahoILIllinoysIAAyovaKSKanzasKYKentukkiLALuizianaMEMenMDMerilendMAMassachusetsMIMichiganMNMinnesotaMSMissisipiMOMissuriMTMontanaNENebraskaNVNevadaNHNyu-HempshirNJNyu-JersiNMNyu-MeksikoNYNyu-YorkNCShimoliy KarolinaNDShimoliy DakotaOHOgayoOKOklaxomaOROregonPAPensilvaniyaRIRod-AylendSCJanubiy KarolinaSDJanubiy DakotaTNTennessiTXTexasUTYutaVTVermontVAVirjiniyaWAVashingtonWVG‘arbiy VirjiniyaWIViskonsinWYVayoming
18 $ – 38 $ / soat
MasofaviyTo‘liq stavkaJuniorTalab Qilinadigan Til: inglizchaAuditor

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.

Ochish
Qlarant

Field Auditor/Investigator II – USDA SNAP Investigations, Remote U.S.

Qlarant
501 – 1 000 Xodimlar
KonsaltingSog‘liqni saqlashSug‘urta
USAmerika Qo‘shma ShtatlariFLFloridaKYKentukkiMEMenMDMerilendMAMassachusetsNJNyu-JersiNYNyu-YorkOHOgayoPAPensilvaniyaTNTennessi
28 $ – 34 $ / soat
MasofaviyTo‘liq stavkaJuniorO‘rta darajaTalab Qilinadigan Til: inglizchaAuditor

Qlarant is seeking a remote Field Auditor/Investigator II to investigate fraud, waste, and abuse involving USDA SNAP retailers. The role covers evidence collection, stakeholder interviews, data analysis, and investigative reporting.

Ochish