Healthcare Data Quality Auditor - Medical Coding

Internationalinsuranceprofessionals; New Mexico; On-site; USD 25,000 - 53,000; Full time

Job summary

CVS Health is seeking a full-time Medical Records Auditor to audit and abstract provider and vendor records to identify CMS ICD codes. You will validate risk adjustment codes for accuracy and compliance with state and federal regulations and organizational policies and procedures.

Responsibilities include supporting coding judgments with evidence, abstracting codes, ensuring proper documentation, meeting deadlines, and upholding HIPAA privacy rules.

Qualifications

• CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician).
• Experience with ICD codes and medical record documentation review.
• Proficient with Microsoft Office and coding applications.

Responsibilities

• Audit and abstract provider and vendor medical records to identify CMS ICD codes.
• Validate risk adjustment codes for accuracy and compliance with regulations and policies.
• Support coding judgments with industry evidence and tools.
• Ensure documentation supports etiology and manifestations of disease processes.
• Adhere to timelines and conduct self-audits to ensure compliance with HIPAA and internal policies.

Skills

CPC/CCS-P

Office Suite

ICD Coding

Audit Experience

Education

AA/AS or equivalent

Tools

Microsoft Office

Job description

CVS Health is seeking a full-time Medical Records Auditor to audit and abstract provider and vendor records to identify CMS ICD codes. You will validate risk adjustment codes for accuracy and compliance with state and federal regulations and organizational policies and procedures.

Responsibilities include supporting coding judgments with evidence, abstracting codes, ensuring proper documentation, meeting deadlines, and upholding HIPAA privacy rules.