ICD Coding & Data Quality Auditor

CVS Health; Wyoming (MI); On-site; USD 25,000 - 49,000; Full time

Benefits offered by this job

Bonus eligible

Comprehensive benefits

Paid time off

Job summary

CVS Health is seeking an experienced Medical Records Auditor/Abstractor to review provider and vendor records, assign ICD codes, and ensure accuracy for CMS risk adjustment programs in accordance with regulations. You will support coding judgments with clinical documentation and adhere to deadlines.

The role requires CPC or CCS-P certification, at least 1 year of related experience, and proficiency with Microsoft Office and coding applications.

Qualifications

• AA/AS or equivalent experience.
• AAPC/AHIMA training program for CPC/CCS-P credentialing.
• Minimum 1 year experience in medical record documentation review, diagnosis coding, or auditing.
• CPC or CCS-P certification required.

Responsibilities

• Review medical records to identify and assign accurate ICD codes.
• Abstract and assign diagnoses as documented by providers.
• Ensure codes are supported by clinical documentation and compliant with regulations.
• Identify clinically active vs historical conditions.
• Ensure etiology and manifestations are documented and justified.
• Adhere to project deadlines and timelines.
• Conduct self-audits to maintain compliance with policies and regulatory guidance.

Skills

CPC/CCS-P

Microsoft Office

ICD coding

Auditing

Education

AA/AS or equivalent experience

AAPC/AHIMA training CPC/CCS-P

Tools

EMR/EHR systems

Coding applications

Job description

CVS Health is seeking an experienced Medical Records Auditor/Abstractor to review provider and vendor records, assign ICD codes, and ensure accuracy for CMS risk adjustment programs in accordance with regulations. You will support coding judgments with clinical documentation and adhere to deadlines.

The role requires CPC or CCS-P certification, at least 1 year of related experience, and proficiency with Microsoft Office and coding applications.