Spec, Coding

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. How will this role have an impact? The Coding Specialist is responsible for verifying and ensuring the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on the documentation and services rendered. The Coding Specialist will be expected to adhere to ICD-10-CM Official Guidelines and any internal guidelines that support accurate and complete capture of the patient’s holistic health picture. What will you do? Review health risk assessments/evaluations to accurately and completely assign all ICD-10 codes that are clinically identified and supported in the assessment/evaluation on a timely basis Identify opportunities to query providers as necessary for clarification of documentation or conflict resolution to enable the proper application of ICD-10 HCC diagnosis codes Communicate timely and effectively with the supervisor regarding issues with the health risk assessments/evaluations and/or corrections required to the health risk assessments/evaluations Understanding the relationship between ICD-10 coding and HCC (hierarchical condition category) coding Maintain adequate knowledge of coding, compliance, and reimbursement procedures related to Medicare Risk Adjustment Make recommendations for coding policy/changes Maintain coding certification after achieving certification status Complete special projects as assigned by management, which require defining problems, and implementing required changes Responsible for the security and privacy of all protected health information that may be accessed during normal work activities We are looking for someone with: Must hold an active CPC, COC, CCS, CCS-P or CCA Current coding certification in good standing CRC preferred Minimum of 1 year of ICD-10 coding experience Prior work experience in the healthcare field specifically related to coding is preferred Experience and knowledge of Medicare, ACA Exchange or Medicaid HCC coding preferred 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 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. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $18.50 - $42.35 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/benefits We anticipate the application window for this opening will close on: 09/19/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area. Apply tot his job Apply To this Job