ICD Coding & Data Quality Auditor

Internationalinsuranceprofessionals; New Hampshire; 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 for CMS coding accuracy and risk adjustment. You will validate documentation to ensure compliance with state and federal regulations, and you will identify active versus historical conditions while maintaining strict HIPAA guidelines.

You will perform self-audits, meet tight timelines, and use industry-standard coding tools and MS Office to support accurate coding and communications with

Qualifications

• CPC or CCS-P credential required.
• Experience with ICD coding and medical record audits.
• 1 year of related experience in medical record review.
• Proficient with MS Office and coding applications.
• Ability to contact providers by phone/fax for records.

Responsibilities

• Audit and abstract provider/ vendor medical records for CMS codes.
• Validate codes for risk adjustment accuracy and compliance.
• Identify active vs historical conditions.
• Ensure documentation supports etiology and disease manifestations.
• Meet project deadlines and conduct self-audits.
• Handle patient data per HIPAA and regulatory guidance.

Skills

Medical coding

Auditing

Communication

HIPAA compliance

Education

AA/AS degree

CPC/CCS-P credential

Tools

Microsoft Office

Job description

CVS Health is seeking a full-time Medical Records Auditor to audit and abstract provider and vendor records for CMS coding accuracy and risk adjustment. You will validate documentation to ensure compliance with state and federal regulations, and you will identify active versus historical conditions while maintaining strict HIPAA guidelines.

You will perform self-audits, meet tight timelines, and use industry-standard coding tools and MS Office to support accurate coding and communications with