CVS Health

CVS Health.

  • Sacramento, CA


  • Irreversible.

  • Full-time.
Task Description

Accountable for carrying out auditing and tracking activities to confirm the quality and precision of information sent to the Centers for Medicare and Medicaid Solutions (CMS) for the Threat Change Payment System (RAPS). Takes part in advancement of audit method and schedule for functional and RI personnel. Displays activity carried out by suppliers, suppliers, and functional personnel to guarantee adherence to developed treatments, regulative standards, and market requirements. Takes part in the education of internal personnel, suppliers, and companies based upon auditing and tracking findings; supplies basic coding education as proper. Uses info obtained through information analytics to target audit activity. Carries out procedure audits to make sure compliance with internal policies and treatments and existing CMS guidelines; recognizes and suggests chances for procedure enhancements so that precision and quality objectives can be fulfilled or surpassed. Supports Threat Change Recognition Audits. Remains present on ICD-10 codes, CMS documents requirements, and State and Federal policies. Carries out other associated responsibilities as needed.

Needed Certifications

– CPC (Qualified Expert Coder) or CCS-P (Qualified Coding Specialist-Physician) needed, CRC within 6 months of hire.

– Minimum of 4 years current and associated experience in medical record paperwork evaluation, medical diagnosis coding, and/or auditing.

– Experience with Medicare and/or Medicaid Threat Change procedure.

– Experience with Microsoft Workplace items (Word, Excel, Job, PowerPoint, Outlook).

– Reliable interaction, organizational and social abilities.

– Exceptional analytical and issue resolving abilities.

Preferred Certifications

– Previous RA experience

Education

Bachelor’s degree or comparable experience

Company Introduction

At Aetna, a CVS Health business, we are participated in a typical function: assisting individuals on their course to much better health. We are working to change healthcare through developments that make quality care more available, much easier to utilize, more economical and patient-focused. Collaborating and arranging around the person, we are pioneering a brand-new technique to overall health that puts individuals at the heart.

We are devoted to preserving a varied and inclusive work environment. CVS Health is a level playing field and affirmative action company. We do not discriminate in recruiting, working with or promo based upon race, ethnic culture, gender, gender identity, age, impairment or secured veteran status. We happily support and motivate individuals with military experience (active, veterans, reservists and National Guard) along with military partners to make an application for CVS Health task chances.

CVS Health.

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