Coding Auditor - Remote

Overview

The Coding Auditor at CVS Health is responsible for ensuring the accuracy and compliance of ICD-10 coding for health risk evaluations of Medicare and Medicaid members, auditing coding work, and collaborating with coding staff to maintain coding standards.

In Short

• Conduct audits on health risk evaluations for accuracy and compliance.
• Review and assign ICD-10 codes based on health assessments.
• Communicate effectively with coding management regarding coding issues.
• Utilize advanced knowledge of coding and CMS protocols.
• Maintain coding certification and compliance with regulations.
• Identify and report coding problems and recommend policy changes.
• Complete special projects as assigned by management.
• Demonstrate teamwork and commitment to coding standards.
• Meet productivity and accuracy targets.
• Stay updated on medical coding guidelines and terminology.

Requirements

• Minimum 4 years of coding audit experience.
• Minimum 6 years of ICD-10 coding experience.
• Experience in the healthcare field, particularly coding.
• Knowledge of Medicare HCC coding and medical documentation.
• Advanced knowledge of medical terminology and anatomy.
• Certification as a CCA, CCS, CCS-P, or CPC required.
• Current coding certification in good standing.
• Basic skills in MS Office and analytical skills.
• High school diploma or equivalent; Associate's or Bachelor's preferred.
• Knowledge of CMS RADV protocols.

Benefits

• Comprehensive medical plan options.
• 401(k) plan with company matching contributions.
• No-cost wellness programs and counseling services.
• Flexible work schedules and paid time off.
• Tuition assistance and family leave options.
• Employee stock purchase plan.
• Retiree medical access and dependent care resources.
• Commitment to diversity and inclusion in the workplace.
• Short-term incentive programs based on performance.
• Opportunities for professional growth and development.