Medical Records Coding & Data Quality Auditor

CVS Health; Saint Paul (MN); On-site; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health seeks a Medical Records Auditor to ensure accurate ICD coding for CMS risk adjustment. You will review provider and vendor charts, abstract diagnoses, and support coding decisions with documentation and regulatory standards.

Responsibilities include timely audits, adherence to CMS/OIG guidelines, and effective communication with clinical and coding teams. Requires CPC/CCS-P credentials and proficiency with ICD coding and Microsoft Office.

Qualifications

• 1 year of medical record documentation review, diagnosis coding, and/or auditing.
• CPC or CCS-P certification required.
• Proficient with ICD coding and Microsoft Office.

Responsibilities

• Audit and abstract medical records to identify and submit ICD codes for CMS risk adjustment.
• Ensure codes are accurate, supported by documentation, and compliant with CMS, OIG and other regulatory guidance.
• Meet project deadlines and conduct self-audits for compliance.
• Collaborate with clinicians and coding teams to resolve discrepancies.

Skills

Medical record auditing

CPC

CCS-P

Microsoft Office

ICD coding

Education

CPC (Certified Professional Coder)

CCS-P (Certified Coding Specialist-Physician)

AA/AS or equivalent

Tools

Microsoft Office

Coding applications

Job description

CVS Health seeks a Medical Records Auditor to ensure accurate ICD coding for CMS risk adjustment. You will review provider and vendor charts, abstract diagnoses, and support coding decisions with documentation and regulatory standards.

Responsibilities include timely audits, adherence to CMS/OIG guidelines, and effective communication with clinical and coding teams. Requires CPC/CCS-P credentials and proficiency with ICD coding and Microsoft Office.