Healthcare Coding & Data Quality Auditor

Internationalinsuranceprofessionals; Oregon; On-site; USD 32,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a Medical Records Auditor/ coder to validate ICD codes for CMS risk adjustment. You will abstract provider records, ensure documentation supports coding decisions, and maintain compliance with state and federal regulations.

The role requires CPC/CCS-P credentials or equivalent, familiarity with ICD coding, and ability to work in a deadline-driven environment. This full-time position offers comprehensive benefits and a competitive pay range in Oregon.

Qualifications

• Proven ability to support coding judgment and decisions using industry standard evidence and tools.

Responsibilities

• Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
• Identify clinically active vs historical conditions.
• Diagnosis codes must be appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures.
• Utilize medical records to ensure support is documented for etiology and manifestations of disease processes.
• Adhere to stringent timelines consistent with project deadlines and directives.
• Conducts self- process audits to ensure compliance with internal policies and procedures as well as regulatory guidance from CMS, OIG or other Regulatory body.
• Required to act in ethical manner at all times as required under HIPAA's Privacy and Security rules to handle patient data with uncompromised adherence to the law.
• In depth knowledge of medical terminology and anatomy for all body systems.-Understand the audit process for risk adjustment models.
• Performs other related duties as required.

Skills

Coding judgment

Medical coding accuracy

Regulatory compliance

Medical terminology knowledge

Education

AA/AS or equivalent

CPC/CCS-P training

Tools

Microsoft Office

Coding software

Job description

CVS Health is seeking a Medical Records Auditor/ coder to validate ICD codes for CMS risk adjustment. You will abstract provider records, ensure documentation supports coding decisions, and maintain compliance with state and federal regulations.

The role requires CPC/CCS-P credentials or equivalent, familiarity with ICD coding, and ability to work in a deadline-driven environment. This full-time position offers comprehensive benefits and a competitive pay range in Oregon.