Medical Coding Quality Auditor - Risk Adjustment

ISHE; Idaho; On-site; USD 25,000 - 53,000; Full time

Benefits offered by this job

Medical, dental & vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a full-time Medical Records Auditor/Abstractor to review provider and vendor records for CMS ICD codes. You will validate coding accuracy, ensure documentation supports risk adjustment, and comply with HIPAA.

Responsibilities include outbound communications for record retrieval, adherence to timelines, and applying coding guidelines. Requires CPC/CCS-P and ICD experience with strong Excel and office software proficiency.

Qualifications

• CPC or CCS-P credential required.
• Computer proficiency including Word, Excel, Access, Outlook.
• Capable of outbound calls/faxes for record retrieval and audits.
• Experience with ICD codes required.
• Minimum 1 year of related medical record coding/auditing experience.

Responsibilities

• Audit and abstract provider/ vendor records to identify CMS ICD codes.
• Ensure codes are accurate, documented, and compliant with regs.
• Identify clinically active vs historical conditions.
• Maintain timely audits per project deadlines.
• Adhere to HIPAA privacy and security rules.

Skills

CPC

CCS-P

ICD coding

Medical terminology

Education

AA/AS or equivalent

AAPC/AHIMA training CPC/CCS-P

Tools

Microsoft Office

coding applications

Job description

CVS Health is seeking a full-time Medical Records Auditor/Abstractor to review provider and vendor records for CMS ICD codes. You will validate coding accuracy, ensure documentation supports risk adjustment, and comply with HIPAA.

Responsibilities include outbound communications for record retrieval, adherence to timelines, and applying coding guidelines. Requires CPC/CCS-P and ICD experience with strong Excel and office software proficiency.