Description
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.
What will you do?
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
We are looking for someone with:
Must hold an active CPC, COC, CCS, CCS-P or CCA
Current coding certification in good standing
CRC preferred
Minimum of 1 year of ICD-10 coding experience
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
About Us:
Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved.
Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.
To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$18.50 - $42.35
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
