Medical Coding & Data Quality Auditor

Internationalinsuranceprofessionals; Tennessee; Hybride; USD 38 000 - 81 000; Plein temps

Avantages offerts par ce poste

Comprehensive benefits

Résumé du poste

CVS Health is seeking a medical records coder/auditor to perform chart reviews, abstract diagnoses, and code validation for CMS risk adjustment. You will work in a collaborative, quality‑driven environment to ensure accuracy and compliance across provider and facility records.

The role requires CPC/CCS‑P certification, 1+ year of related experience, proficiency with ICD coding, and strong attention to detail. Full‑time hours with generous benefits are offered in Tennessee.

Qualifications

• CPC or CCS-P certification required.
• Experience with ICD coding and medical record documentation review.
• Proficient in Microsoft Office and relevant coding applications.
• Ability to contact providers to retrieve records for audits.
• Minimum 1 year of related experience in medical record auditing.

Responsabilités

• Audit and abstract provider and/or vendor medical records for CMS coding.
• Validate codes used for risk adjustment against documentation and regulations.
• Support coding judgments with industry-standard evidence and tools.
• Identify clinically active vs historical conditions in records.
• Ensure diagnoses are accurate and well-supported by documentation.
• Adhere to timelines and project deadlines for audits.
• Perform self-audits to ensure policy and regulatory compliance, HIPAA included.
• Apply medical terminology and anatomy knowledge to audits.
• Carry out related duties as required.

Connaissances

CPC/CCS-P

MS Office proficiency

Provider communications

ICD coding experience

Formation

AA/AS or equivalent

AAPC/AHIMA CPC/CCS-P training

Outils

Microsoft Office suite

Description du poste

CVS Health is seeking a medical records coder/auditor to perform chart reviews, abstract diagnoses, and code validation for CMS risk adjustment. You will work in a collaborative, quality‑driven environment to ensure accuracy and compliance across provider and facility records.

The role requires CPC/CCS‑P certification, 1+ year of related experience, proficiency with ICD coding, and strong attention to detail. Full‑time hours with generous benefits are offered in Tennessee.