Healthcare Data Quality Auditor — Coding & Compliance

Colorado Psychiatric; Colorado; On-site; USD 25,000 - 52,000; Full time

Job summary

CVS Health is seeking a full-time Medical Records Auditor to audit and abstract provider and vendor records, ensuring accurate ICD coding for CMS submissions and compliance with state/federal regulations. You will support coding decisions, review documentation for medical necessity, and maintain strict HIPAA standards.

The role requires CPC/CCS-P or equivalent training, 1+ year of related experience, and proficiency with ICD coding, Microsoft Office, and coding applications.

Qualifications

• Proven ability to support coding judgment using industry standard evidence and tools.
• Experience with ICD codes required.
• Knowledge of coding guidelines and regulations to meet compliance requirements.
• Capable of outbound provider communications for record retrieval.

Responsibilities

• Audit and abstract provider and/or vendor medical records to identify ICD codes for CMS submissions.
• Validate that risk adjustment codes are accurate and well documented.
• Adhere to timelines and internal policies; conduct self-audits for compliance.
• Handle patient data in accordance with HIPAA Privacy and Security rules.

Skills

Coding judgment

ICD codes

Medical terminology

Regulatory compliance

Provider communications

Education

AA/AS or equivalent

CPC/CCS-P training (AAPC/AHIMA)

Tools

Microsoft Office

Coding applications

Job description

CVS Health is seeking a full-time Medical Records Auditor to audit and abstract provider and vendor records, ensuring accurate ICD coding for CMS submissions and compliance with state/federal regulations. You will support coding decisions, review documentation for medical necessity, and maintain strict HIPAA standards.

The role requires CPC/CCS-P or equivalent training, 1+ year of related experience, and proficiency with ICD coding, Microsoft Office, and coding applications.