Medical Coding & Data Quality Auditor

Internationalinsuranceprofessionals; South Dakota; On-site; USD 25,000 - 52,000; Full time

Job summary

CVS Health is seeking a Medical Records Auditor to perform audit and abstraction of provider and vendor records, ensuring accurate ICD coding for CMS risk adjustment. The role requires CPC or CCS-P, ICD coding experience, and 1+ year in medical record review, auditing, and related duties.

This full-time, on-site position offers comprehensive benefits and a competitive pay range, with hourly wages from $18.50 to $38.82, dependent on experience and geography.

Qualifications

• CPC or CCS-P certification required.
• Proficient in Microsoft Office applications.
• Ability to perform outbound calls and faxes for record retrieval.
• Experience with ICD coding is required.
• Minimum 1 year of medical record documentation review, diagnosis coding, and/or auditing.

Responsibilities

• Audit and abstraction of provider and/or vendor medical records to identify ICD codes submitted to CMS.
• Validate codes used for risk adjustment are accurate, documented, and compliant with policies.
• Adhere to timelines and conduct self-audits to ensure compliance with CMS and HIPAA guidance.
• Handle patient data in accordance with HIPAA Privacy and Security rules.

Skills

CPC/CCS-P credential

Microsoft Office

Phone outreach

ICD coding

Medical record review

Education

AA/AS or equivalent

CPC/CCS-P training completion

Job description

CVS Health is seeking a Medical Records Auditor to perform audit and abstraction of provider and vendor records, ensuring accurate ICD coding for CMS risk adjustment. The role requires CPC or CCS-P, ICD coding experience, and 1+ year in medical record review, auditing, and related duties.

This full-time, on-site position offers comprehensive benefits and a competitive pay range, with hourly wages from $18.50 to $38.82, dependent on experience and geography.