Medical Coding & Data Quality Auditor

Internationalinsuranceprofessionals; Maryland; On-site; USD 26,000 - 52,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Retirement options

Bonus eligibility

Job summary

CVS Health is seeking a Medical Records Auditor with certification in CPC or CCS-P to audit and abstract provider records for ICD coding used in CMS risk adjustment. You will verify accuracy and documentation, while complying with HIPAA and regulatory guidelines. Strong Excel/Office skills and prior coding/audit experience are required.

The role is full-time with 40 hours per week, based in Maryland. A comprehensive benefits package, competitive pay, and bonus eligibility are included.

Qualifications

• 1 year of medical record documentation review, diagnosis coding, and/or auditing.
• Experience with ICD codes required.
• Capable of outbound provider communications and record retrieval.

Responsibilities

• Audit and abstract medical records to identify CMS-submitted ICD codes.
• Validate accuracy and documentation for risk adjustment codes.
• Ensure compliance with CMS, OIG and other regulatory guidance.
• Adhere to timelines and internal policies for audits.
• Handle patient data in accordance with HIPAA requirements.

Skills

CPC

CCS-P

ICD coding

MS Office

Record retrieval

Education

AA/AS or equivalent

CPC/CCS-P training program

Tools

Industry coding applications

Job description

CVS Health is seeking a Medical Records Auditor with certification in CPC or CCS-P to audit and abstract provider records for ICD coding used in CMS risk adjustment. You will verify accuracy and documentation, while complying with HIPAA and regulatory guidelines. Strong Excel/Office skills and prior coding/audit experience are required.

The role is full-time with 40 hours per week, based in Maryland. A comprehensive benefits package, competitive pay, and bonus eligibility are included.