CVS Health-posted 3 months ago
$18 - $42/Yr
Full-time • Entry Level
Work At Home, KY
5,001-10,000 employees
Ambulatory Health Care Services

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Position Summary: Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures.

  • Perform audit and abstraction of medical records to identify and submit ICD codes.
  • Support coding judgment and decisions using industry standard evidence and tools.
  • Abstract and assign accurate medical codes for diagnoses as documented by healthcare providers.
  • Ensure compliance with coding guidelines and regulations.
  • Identify clinically active vs. historical conditions.
  • Utilize medical records to document support for disease processes.
  • Adhere to stringent timelines consistent with project deadlines.
  • Conduct self-process audits to ensure compliance with internal policies and regulatory guidance.
  • Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
  • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required.
  • CRC (Certified Risk Adjustment Coder) required.
  • Computer proficiency including experience with Microsoft Office products.
  • Experience with International Classification of Disease (ICD) codes required.
  • Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred.
  • Affordable medical plan options.
  • 401(k) plan including matching company contributions.
  • Employee stock purchase plan.
  • No-cost wellness screenings, tobacco cessation and weight management programs.
  • Confidential counseling and financial coaching.
  • Paid time off and flexible work schedules.
  • Family leave and dependent care resources.
  • Tuition assistance and retiree medical access.
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