Medical Coding Data Quality Auditor

CVS Health; Minneota (MN); On-site; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a dedicated Medical Records Auditor/ coder to perform audit and abstraction of medical records for CMS risk adjustment, ensuring codes are accurate, supported by clinical documentation, and compliant with regulatory guidelines. You will use standard coding practices and tools to support coding decisions in a 40-hour workweek.

Required CPC or CCS-P and at least 1 year of related experience, plus proficiency with Microsoft Office and ICD codes.

Qualifications

• Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
• CPC or CCS-P required.
• Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications).
• Experience with ICD codes required.

Responsibilities

• Audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment.
• Support coding judgment using industry standard evidence and tools.
• Assign accurate medical codes for diagnoses as documented by clinicians.
• Ensure codes are supported by clinical documentation and compliant with regulations.
• Meet project deadlines and adhere to internal policies and regulatory guidance.

Skills

Medical coding

Auditing

CMS risk adjustment

Education

AA/AS or equivalent experience

AAPC/AHIMA CPC/CCS-P training

Tools

Microsoft Office

Coding applications

Job description

CVS Health is seeking a dedicated Medical Records Auditor/ coder to perform audit and abstraction of medical records for CMS risk adjustment, ensuring codes are accurate, supported by clinical documentation, and compliant with regulatory guidelines. You will use standard coding practices and tools to support coding decisions in a 40-hour workweek.

Required CPC or CCS-P and at least 1 year of related experience, plus proficiency with Microsoft Office and ICD codes.