CVS Health

Bringing our heart to every moment of your health.

Senior Quality Analyst

AnalystAnalystFull TimeRemoteTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

Florida + 2 moreAll locations: Florida, Idaho, Vermont

Posted

17 days ago

Salary

$47.0K - $112.2K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Responsible for conducting complex audits, reviews and assessments of medical records • Contributes to compliance reporting and documentation • Demonstrated ability to apply coding judgment and make decisions using industry-standard evidence and tools • Adhere to stringent timelines consistent with project deadlines and directives • Serves as the training resource and subject matter expert to vendors, providers and team members for questions regarding ICD coding and documentation requirements • Identify and communicate documentation deficiencies • Acts as mentor to provide education to internal staff based on audit findings • Communicates with corporate legal and compliance teams to ensure accurate reporting to external authorities

Job Requirements

  • Minimum of 5 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
  • Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 5 years for CPC
  • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
  • CPMA (Certified Professional Medical Auditor) or CDEO (Certified Documentation Expert Outpatient) preferred
  • Experience with International Classification of Disease (ICD) codes required

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
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

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