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Coding Data Quality Auditor
Location
Idaho + 2 moreAll locations: Idaho | Missouri | Vermont
Posted
112 days ago
Salary
$21 - $44 / hour
Seniority
Senior
Job Description
Coding Data Quality Auditor
CVS Health
• Responsible for performing quality inter-rater review audits of medical records coded by internal team (CDQA and Sr CDQA) • Ensure the ICD-10 codes that are submitted to CMS are appropriate, accurate, and supported by clinical documentation • Proven ability to support coding judgment and decisions using industry standard evidence and tools • Confidently communicate with stakeholders across varying knowledge and clinical expertise • Conduct process audits to ensure compliance with internal policies and CMS regulations • Work independently and collaborate with other teams for best practices • Improve and promote quality; assist others through mentoring and instruction • Expertise in assigning accurate medical codes for diagnoses • Knowledge of coding guidelines and regulations to meet compliance requirements • Perform other related duties as required
Job Requirements
- Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications)
- Experience with International Classification of Disease (ICD) codes required
- 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
- CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
- Excellent analytical and problem-solving skills
- Superior communication, organizational, and interpersonal skills
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
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