Massachusetts Jobs

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.

Job Description

Primary Job Duties & Responsibilities Ensures accurate coding and documentation of medical services, procedures, and diagnoses to support proper reimbursement and revenue generation.

Assigns appropriate medical codes to diagnoses, procedures, and services based on detailed medical documentation.

Reviews medical records, operative reports, and other relevant documents to accurately capture all billable services and ensure compliance with coding guidelines and regulations.

Conducts coding audits and reviews to assess coding accuracy, compliance, and documentation completeness.

Collaborates with revenue cycle management teams to optimize the coding process and ensure proper documentation for billing and reimbursement.

Provides training and education to Revenue Cycle staff, healthcare providers, and other stakeholders to improve coding knowledge, accuracy, and documentation practices.

Identifies areas for improvement and provides feedback to team members and key healthcare providers to enhance coding practices and ensure proper revenue capture.

Utilizes leading-edge software, systems, and tools to support team activities, maintain data integrity, and generate accurate reports.

Provides guidance, support, and mentorship, including junior team members by assisting with training initiatives, knowledge sharing, and performance evaluations to develop and enhance the skills development and competencies of the team.

Required Qualifications

Prior Relevant Work Experience 5+ years

Preferred Qualifications

Adept at problem solving and decision making skills Certified Billing and Coding Specialist (CBCS) preferred.

Education

High school diploma or equivalent

Pay Range

The typical pay range for this role is:

$18.50 - $38.82

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits)

We anticipate the application window for this opening will close on: 01/04/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.