Medical Coding Data Quality Auditor for Accurate ICD Coding

Internationalinsuranceprofessionals; Mississippi; On-site; USD 53,038,000 - 104,698,000; Full time

Benefits offered by this job

Health insurance

Dental and vision coverage

Paid time off

Retirement savings options

Wellness programs

Comprehensive benefits package

Job summary

CVS Health is seeking a full-time Medical Records Auditor to review and abstract provider and vendor records for CMS coding accuracy. You will ensure diagnoses and risk-adjustment codes are properly documented and compliant with state and federal regulations.

The role requires CPC/CCS-P certification, ICD coding experience, and proficiency with MS Office. A minimum of 1 year in medical record documentation review, coding, or auditing is expected.

Qualifications

• CPC or CCS-P certification required.
• Experience with ICD coding and medical record audits.
• Proficient with MS Office and basic office software.
• 1 year of relevant experience in medical record documentation review, coding, or auditing.

Responsibilities

• Audit and abstract provider and vendor medical records to identify CMS codes.
• Validate that codes used for risk adjustment are accurate and compliant with regulations.
• Support coding judgments using industry-standard evidence and tools.
• Identify clinically active vs. historical conditions and ensure proper documentation.
• Adhere to timelines and project deadlines; conduct self-audit for compliance.
• Handle patient data in accordance with HIPAA Privacy and Security rules.

Skills

ICD coding knowledge

MS Office proficiency

Outbound communications

Medical records abstraction

HIPAA knowledge

Education

AA/AS or equivalent

CPC/CCS-P training completion

Job description

CVS Health is seeking a full-time Medical Records Auditor to review and abstract provider and vendor records for CMS coding accuracy. You will ensure diagnoses and risk-adjustment codes are properly documented and compliant with state and federal regulations.

The role requires CPC/CCS-P certification, ICD coding experience, and proficiency with MS Office. A minimum of 1 year in medical record documentation review, coding, or auditing is expected.