Spec,Coding

CVS Health•Work At Home-Iowa, IA

1d•Remote

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. Under the supervision of the Manager of Coding, this position is responsible for ICD-10 coding of Health Risk Evaluations of Medicare and Medicaid members that are performed by the Signify Health physicians and reviewing the Health Risk Assessments/Evaluations to insure completeness, accuracy and compliance with CMS guidelines.

Requirements

Must hold an active CPC, CPC-A, COC, CCS, CCS-P or CCA
Current coding certification in good standing.
CRC required
ICD-10 Coding Certification will be required
Minimum of 1 year of experience of ICD-10 coding.
Experience and knowledge of Medicare HCC coding.
Experience with medical record documentation.
Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology

Nice To Haves

Prior work experience in the healthcare field specifically related to coding is preferred.
Prior medical chart auditing/quality experience preferred.

Responsibilities

Reviews health risk assessments/evaluations to determine completion and compliance with CMS guidelines on a timely basis.
Reviews and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes identified in the health risk assessments/evaluations.
Reviews health risk assessments/evaluations to accurately and completely assign all ICD-9/10 codes that are clinically identified and supported in the assessment/evaluation on a timely basis.
Communicates timely and effectively with supervisor regarding issues with the health risk assessments/evaluations and/or corrections required to the health risk assessments/evaluations.
Understanding the relationship between IC-9/10 coding and HCC (hierarchical condition category) coding.
Utilizes advanced, specialized knowledge of medical codes and coding protocol by providing guidance to the Director of Coding to ensure the organization is following Medicare coding protocol for payment of claims.
Demonstrate a commitment to integrating coding compliance standard into coding practices.
Identify, correct and report coding problems.
Maintain adequate knowledge of compliant coding procedures related top Medicare Risk Adjustment.
Maintain coding credentials
Complete special projects as assigned by management, which require defining problems, and implementing required changes.
Follows all legal and policy requirements for HIPAA protected data.
Actively demonstrates teamwork at all times.
Ability to work overtime.
Is able to meet and maintain required accuracy and efficiency standards.