Clinical Data Quality Auditor & Medical Coding Expert

CVS Health; Lake Michigan Beach (MI); Presencial; USD 26.000 - 48.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement plan

Wellness program

Descripción de la vacante

CVS Health is seeking a dedicated coder/audit professional to review medical records and abstract accurate ICD codes for CMS risk adjustment programs. You will ensure documentation supports coding decisions with compliance to state and federal regulations.

The role requires CPC/CCS-P credentials and at least 1 year of related experience, plus strong proficiency in MS Office and ICD coding systems. A supportive benefits package is included with full-time employment.

Formación

• Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
• CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required.
• Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications).
• Experience with International Classification of Disease (ICD) codes required.

Responsabilidades

• Audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment processes.
• Support coding judgment and decisions using industry standard evidence and tools.
• Assign accurate medical codes for diagnoses documented by physicians and providers.
• Adhere to regulations and internal policies, ensuring medical necessity and compliance.

Conocimientos

CPC or CCS-P

Medical record review

ICD coding

Microsoft Office proficiency

Audit experience

Educación

AA/AS or equivalent

AAPC/AHIMA training program

Herramientas

MS Office

Descripción del empleo

CVS Health is seeking a dedicated coder/audit professional to review medical records and abstract accurate ICD codes for CMS risk adjustment programs. You will ensure documentation supports coding decisions with compliance to state and federal regulations.

The role requires CPC/CCS-P credentials and at least 1 year of related experience, plus strong proficiency in MS Office and ICD coding systems. A supportive benefits package is included with full-time employment.