Medical Coding & Data Quality Auditor

CVS Health; Iowa City (IA); On-site; USD 25,000 - 49,000; Full time

Job summary

CVS Health is seeking a Medical Records Audit/Coding professional to review records, abstract ICD codes, and ensure medical necessity for CMS risk adjustment. You will support coding judgments, verify active conditions, and ensure compliance with coding guidelines in a fast-paced environment.

Qualifications include 1 year of related experience, CPC or CCS-P credentials, and proficiency with ICD coding and Microsoft Office.

Qualifications

• Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
• Experience with ICD codes required.
• CPC or CCS-P certification required or CPC/CCS-P credential.
• Proficiency with Microsoft Office products and industry standard coding applications.

Responsibilities

• Audit and abstraction of medical records to identify ICD codes for CMS risk adjustment.
• Support coding judgment using industry standards and tools.
• Assign accurate diagnoses as documented by physicians and providers.
• Ensure compliance with coding guidelines and regulations; establish medical necessity.
• Identify active vs historical conditions and verify etiology and manifestations.
• Meet project deadlines and conduct self-audit for policy compliance.

Skills

Medical records review

Coding accuracy

Audit experience

Education

AA/AS or equivalent

AAPC/AHIMA training (CPC/CCS-P)

Tools

Microsoft Office

Coding applications

Job description

CVS Health is seeking a Medical Records Audit/Coding professional to review records, abstract ICD codes, and ensure medical necessity for CMS risk adjustment. You will support coding judgments, verify active conditions, and ensure compliance with coding guidelines in a fast-paced environment.

Qualifications include 1 year of related experience, CPC or CCS-P credentials, and proficiency with ICD coding and Microsoft Office.