Healthcare Data Quality Auditor: Coding & Risk Adjustment

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

Benefits offered by this job

Medical benefits

Dental and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health seeks a professional to audit and abstract medical records to identify CMS ICD codes and ensure accurate risk adjustment coding. The role requires coding certification, strong knowledge of ICD codes, and compliance with HIPAA regulations.

You'll use Microsoft Office and coding applications to support audits, liaising with providers for record retrieval while meeting strict deadlines and maintaining data security.

Qualifications

• CPC or CCS-P certification required.
• Experience with ICD coding and medical record review.
• Proficiency in Office products and coding systems.

Responsibilities

• Audit and abstract provider/vendor medical records for CMS ICD codes.
• Validate accuracy and documentation for risk adjustment processes.
• Ensure compliance with HIPAA and regulatory guidelines.
• Contact providers for records and communicate audits.

Skills

Medical coding

HIPAA compliance

Communication

Education

AA/AS or equivalent

CPC/CCS-P training

Tools

Microsoft Office

coding applications

Job description

CVS Health seeks a professional to audit and abstract medical records to identify CMS ICD codes and ensure accurate risk adjustment coding. The role requires coding certification, strong knowledge of ICD codes, and compliance with HIPAA regulations.

You'll use Microsoft Office and coding applications to support audits, liaising with providers for record retrieval while meeting strict deadlines and maintaining data security.