Medical Coding & Data Quality Auditor

Internationalinsuranceprofessionals; Missouri; On-site; USD 38,000 - 81,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health in Missouri is seeking a Medical Records Auditor to review provider and vendor records, abstract ICD codes, and ensure accurate coding for CMS risk adjustment. You will verify documentation supports diagnoses and compliance with state, federal regulations, and internal policies.

Responsibilities include performing audits, communicating with providers, meeting tight deadlines, and maintaining HIPAA privacy standards while leveraging ICD coding knowledge and office software to support

Qualifications

• AA/AS or equivalent experience in healthcare coding and auditing.
• Completion of CPC/CCS-P training with relevant work history.
• Experience with ICD coding and medical record review.

Responsibilities

• Audit and abstract provider/vendor records to support CMS risk adjustment.
• Ensure codes are accurate, documented, and compliant with regulations.
• Identify clinically active vs historical conditions and ensure medical necessity.
• Communicate with providers for record retrieval and audits.
• Meet project deadlines and maintain HIPAA privacy standards.

Skills

Medical coding knowledge

Audit skills

HIPAA compliance

Communication skills

Problem solving

Education

AA/AS or equivalent

CPC or CCS-P certification training

Tools

Microsoft Office

Industry coding applications

Job description

CVS Health in Missouri is seeking a Medical Records Auditor to review provider and vendor records, abstract ICD codes, and ensure accurate coding for CMS risk adjustment. You will verify documentation supports diagnoses and compliance with state, federal regulations, and internal policies.

Responsibilities include performing audits, communicating with providers, meeting tight deadlines, and maintaining HIPAA privacy standards while leveraging ICD coding knowledge and office software to support