CVS Health

Bringing our heart to every moment of your health.

Coding Data Quality Auditor, Analyst

AuditorAuditorFull TimeRemoteSeniorTeam 10,001+Since 1963H1B No SponsorCompany Site LinkedIn

Location

Alabama + 3 more

Posted

19 days ago

Salary

$21 - $44 / hour

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

• Responsible for performing quality inter-rater review audits of medical records coded by internal team • Leads dispute resolution • Acts as mentor to provide education to internal staff based on audit findings • Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations • Identifies and recommends opportunities for process improvements • Adhere to stringent timelines consistent with project deadlines and directives

Job Requirements

CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
Experience with International Classification of Disease (ICD) codes required
Minimum of 3 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required
Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications)

Benefits

Affordable medical plan options
401(k) plan (including matching company contributions)
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