Analyst, Coding Data Quality Auditor
CVS HealthSalary not specified
Full Time
Mid-level (3 to 4 years), Senior (5 to 8 years)
Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries
Requirements
- H.S. diploma or equivalent
- Minimum of 3 years of experience as coder of medical records in physician office, hospital, or insurance/coding office setting (or equivalent combination of education and experience)
- CPC or CRC Certification
Responsibilities
- Audits coders that diagnosis data retrieved from physician and hospital medical records and/or data extract files for both revenue project and RADV
- Assists with National and Targeted Risk Adjustment Data Validation audits
- Participates and represents the department in business leadership groups
- Serves as a subject matter expert
- Assesses and identifies training opportunities
- Maintains current knowledge of requirements and guidance required in the performance of audit duties
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
Is this position remote or virtual?
This is a virtual role enabling associates to work full-time from home, except for required in-person training sessions when indicated. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless accommodation is granted.
What are the minimum qualifications for this role?
A high school diploma or equivalent and a minimum of 3 years of experience as a coder of medical records in a physician office, hospital, or insurance/coding office setting are required, or equivalent combination of education and experience.
What certifications are required or preferred for this position?
CPC or CRC Certification is needed. Medical Coder certification from accredited sources like AHIMA, AAPC, or PMI is preferred, along with experience in ICD-10, CPT, CPTII, and HCC coding.
What are the working hours for this job?
The position follows an 8:00a - 5:00p schedule, Monday through Friday.
What experience makes a candidate stand out for this role?
Candidates with experience in Medicare Advantage and Medicaid, ICD-10 coding, CPT and CPTII, HCC coding, familiarity with electronic indexes, and telehealth visits are preferred, in addition to the required CPC or CRC certification.
Elevance Health
Integrated health services and digital platform
About Elevance Health
Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.
Indianapolis, IndianaHeadquarters
1944Year Founded
$309.4MTotal Funding
IPOCompany Stage
Enterprise Software, Social Impact, HealthcareIndustries
10,001+Employees