At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
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. 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
Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.
We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.
Anticipated Weekly Hours40
Time TypeFull time
Pay Range
The typical pay range for this role is:$18.50 – $31.72
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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.
For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 04/01/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.