Healthcare Coding & Data Quality Auditor

Internationalinsuranceprofessionals; Virginia; On-site; USD 26,000 - 54,000; Full time

Benefits offered by this job

Health benefits (medical, dental, and-

Paid time off

Retirement plan

Wellness programs

Vision coverage

Job summary

CVS Health is seeking a Medical Records Auditor to review and abstract provider and vendor records for CMS coding accuracy. You will ensure documentation supports diagnoses and risk adjustment data, adhering to HIPAA and regulatory standards.

The role requires knowledge of ICD codes, coding guidelines, and strong communication skills for provider outreach. A minimum of one year in medical record review or auditing is expected, with a 40-hour workweek and full-time employment.

Qualifications

• CPC or CCS-P certification is required.
• 1 year of recent medical record review, coding or auditing experience.
• Experience with ICD coding and provider record retrieval.
• Familiarity with HIPAA privacy and security rules.

Responsibilities

• Audit and abstract provider/vendor medical records for CMS coding.
• Ensure codes are accurate and compliant with state and federal regulations.
• Maintain timelines and meet project deadlines.
• Communicate findings to providers as part of audits.
• Conduct self-audits to ensure policy compliance.

Skills

CPC/CCS-P

Outbound calls

ICD coding

HIPAA compliance

Microsoft Office

Education

AA/AS or equivalent

AAPC/AHIMA credential training

Tools

Microsoft Office (Word Excel Access PowerPoint Outlook)

Job description

CVS Health is seeking a Medical Records Auditor to review and abstract provider and vendor records for CMS coding accuracy. You will ensure documentation supports diagnoses and risk adjustment data, adhering to HIPAA and regulatory standards.

The role requires knowledge of ICD codes, coding guidelines, and strong communication skills for provider outreach. A minimum of one year in medical record review or auditing is expected, with a 40-hour workweek and full-time employment.