Medical Coding & Data Quality Auditor

Internationalinsuranceprofessionals; Wisconsin; On-site; USD 25,000 - 53,000; Full time

Benefits offered by this job

Medical insurance

Dental and vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Health Information Auditor responsible for auditing and abstracting provider and vendor medical records to identify ICD codes submitted to CMS. You will ensure codes are accurate, documented properly, and compliant with state and federal regulations while maintaining high quality and meeting deadlines.

The role requires CPC/CCS-P certification, proficiency with ICD coding, and strong knowledge of HIPAA privacy rules.

Qualifications

• CPC or CCS-P certification required.
• Experience with ICD coding and medical record documentation.
• Proficient in using Microsoft Office and coding applications.

Responsibilities

• Audit and abstract provider or vendor medical records.
• Ensure accurate ICD coding for CMS and risk adjustment.
• Maintain compliance with HIPAA and regulatory guidelines.
• Identify active vs historical conditions and support medical necessity.
• Meet project deadlines and perform self-audits for quality control.
• Communicate with providers to retrieve records.

Skills

CPC/CCS-P credentials

Microsoft Office

Record retrieval calls

Education

AA/AS or equivalent

CPC/CCS-P training program

Tools

Office suite

Job description

CVS Health is seeking a Health Information Auditor responsible for auditing and abstracting provider and vendor medical records to identify ICD codes submitted to CMS. You will ensure codes are accurate, documented properly, and compliant with state and federal regulations while maintaining high quality and meeting deadlines.

The role requires CPC/CCS-P certification, proficiency with ICD coding, and strong knowledge of HIPAA privacy rules.