Healthcare Coding Quality Auditor

Internationalinsuranceprofessionals; Rhode Island; On-site; USD 26,000 - 52,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Medical Records Auditor/Coder to review and abstract provider and vendor records for CMS ICD codes. You will validate risk-adjustment codes, ensure documentation supports diagnoses, and maintain HIPAA compliance.

The role requires CPC/CCS-P credentials, proficiency with ICD coding, and strong communication with providers for record retrieval. Full-time, on-site with competitive benefits and 40-hour weeks.

Qualifications

• AA/AS or equivalent experience is required.
• CPC or CCS-P certification is required or preferred.
• Experience with ICD codes is required.
• Proficiency with Microsoft Office suite and coding applications.

Responsibilities

• Audit and abstract provider or vendor medical records to identify CMS ICD codes.
• Validate codes used for risk adjustment are accurate and compliant with regulations.
• Identify clinically active vs historical conditions and ensure documentation supports diagnosis.
• Adhere to HIPAA Privacy and Security rules in handling patient data.
• Meet project deadlines and conduct self-audit for compliance with policies.

Skills

Medical coding

Office software

ICD codes knowledge

Outbound provider communication

Education

AA/AS or equivalent

AAPC/AHIMA CPC/CCS-P training

Tools

Microsoft Office

Coding applications

Job description

CVS Health is seeking a Medical Records Auditor/Coder to review and abstract provider and vendor records for CMS ICD codes. You will validate risk-adjustment codes, ensure documentation supports diagnoses, and maintain HIPAA compliance.

The role requires CPC/CCS-P credentials, proficiency with ICD coding, and strong communication with providers for record retrieval. Full-time, on-site with competitive benefits and 40-hour weeks.