Job 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. 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. What will you do? 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. We are looking for someone with: 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. Prior work experience in the healthcare field specifically related to coding is preferred. Experience and knowledge of Medicare HCC coding. 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 As Signifiers, we are the heart of our culture. We define and build it - from how we treat each other, to responding to our members’ needs and serving our communities. Living our Heart At Work Behaviors™ in every interaction every day helps us to put our purpose into action for our customers and members and create a workplace where we can all thrive. Every Signifier plays an important role in creating the culture we need, want, and deserve. We do this by putting people first, joining forces, creating simplicity, championing safety and quality, rising to the challenge, and inspiring trust. Join our team and bring your heart to work as we innovate and deliver solutions to make health care more personal, convenient and affordable. The base salary hiring range for this position is $18.50 to $35.29. Compensation offered will be determined by factors such as location, level, job-related knowledge, skills, and experience. Certain roles may be eligible for incentive compensation, equity, and benefits. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. Eligible employees may enroll in a full range of medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also offer education assistance, free development courses, paid time off programs, paid holidays, a CVS store discount, and discount programs with participating partners. 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