Healthcare Data Quality & Coding Auditor

Internationalinsuranceprofessionals; Indiana; On-site; USD 32,000 - 52,000; Full time

Benefits offered by this job

Medical, dental & vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is looking for a Medical Records Coder to audit and abstract provider and vendor records, ensuring accurate ICD coding for CMS risk adjustment. You will verify documentation supports medical necessity while adhering to HIPAA and regulatory requirements.

The role requires at least 1 year of related experience, CPC/CCS-P credentials, and proficiency with MS Office. Full-time, on-site in the United States with competitive benefits.

Qualifications

• Proficient in coding and record abstraction for ICD codes.
• Familiar with CMS, OIG regulations and risk adjustment guidance.
• Ability to interpret medical documentation and support coding decisions.
• Experience with record retrieval and provider communications.

Responsibilities

• Audit and abstract provider/ vendor medical records for ICD codes.
• Validate coding accuracy and documentation for risk adjustment.
• Ensure compliance with CMS, HIPAA, and internal policies.
• Meet strict project deadlines and maintain data integrity.

Skills

Medical coding

HIPAA compliance

Attention to detail

Communication

Education

CPC or CCS-P credential

AA/AS or equivalent

Tools

Microsoft Office

Job description

CVS Health is looking for a Medical Records Coder to audit and abstract provider and vendor records, ensuring accurate ICD coding for CMS risk adjustment. You will verify documentation supports medical necessity while adhering to HIPAA and regulatory requirements.

The role requires at least 1 year of related experience, CPC/CCS-P credentials, and proficiency with MS Office. Full-time, on-site in the United States with competitive benefits.