Spec, Coding

CVS Health

22h • $19 - $42

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. How will this role have an impact? The Coding Specialist is responsible for verifying and ensuring the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on the documentation and services rendered. The Coding Specialist will be expected to adhere to ICD-10-CM Official Guidelines and any internal guidelines that support accurate and complete capture of the patient’s holistic health picture.

Requirements

• Must hold an active CPC, COC, CCS, CCS-P or CCA
• Current coding certification in good standing
• Minimum of 1 year of ICD-10 coding experience

Nice To Haves

• CRC preferred
• Prior work experience in the healthcare field specifically related to coding is preferred
• Experience and knowledge of Medicare, ACA Exchange or Medicaid HCC coding preferred
• Experience with medical record documentation
• Prior medical chart auditing/quality experience preferred
• Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology

Responsibilities

• Review health risk assessments/evaluations to accurately and completely assign all ICD-10 codes that are clinically identified and supported in the assessment/evaluation on a timely basis
• Identify opportunities to query providers as necessary for clarification of documentation or conflict resolution to enable the proper application of ICD-10 HCC diagnosis codes
• Communicate timely and effectively with the supervisor regarding issues with the health risk assessments/evaluations and/or corrections required to the health risk assessments/evaluations
• Understanding the relationship between ICD-10 coding and HCC (hierarchical condition category) coding
• Maintain adequate knowledge of coding, compliance, and reimbursement procedures related to Medicare Risk Adjustment
• Make recommendations for coding policy/changes
• Maintain coding certification after achieving certification status
• Complete special projects as assigned by management, which require defining problems, and implementing required changes
• Responsible for the security and privacy of all protected health information that may be accessed during normal work activities

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed