Medical Records Coding & Quality Auditor

CVS Health; Iowa Center (IA); On-site; USD 25,000 - 49,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Eligibility for bonus

Job summary

CVS Health is seeking a Medical Records Auditor to perform audit and abstraction of records to identify and submit ICD codes for CMS risk adjustment. You will support coding decisions, ensure medical necessity, and adhere to CMS and internal policies in a fast-paced environment.

The role requires 1+ year experience in medical record review, CPC/CCS-P certification, and proficiency with ICD coding and Microsoft Office. 40 hours per week with comprehensive benefits.

Qualifications

• Minimum of 1 year recent experience in medical record documentation review, diagnosis coding, and/or auditing.
• CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required.
• Computer proficiency including experience with Microsoft Office products and coding applications.
• Experience with ICD codes required.

Responsibilities

• Audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment.
• Support coding judgment using industry standard evidence and tools.
• Assign medical codes for diagnoses as documented by physicians and providers.
• Adhere to guidelines to meet compliance and medical necessity.
• Identify clinically active vs historical conditions.
• Ensure codes are supported by clinical documentation and regulations.
• Utilize records to ensure etiology and manifestations are documented.
• Meet project deadlines and directives.
• Conduct self-audit to ensure compliance with internal policies and CMS/OIG guidance.

Skills

Auditing

Coding judgement

Medical records review

Time management

Education

AA/AS or equivalent experience

AAPC/AHIMA CPC/CCS-P training

Tools

Microsoft Office

Coding applications

Job description

CVS Health is seeking a Medical Records Auditor to perform audit and abstraction of records to identify and submit ICD codes for CMS risk adjustment. You will support coding decisions, ensure medical necessity, and adhere to CMS and internal policies in a fast-paced environment.

The role requires 1+ year experience in medical record review, CPC/CCS-P certification, and proficiency with ICD coding and Microsoft Office. 40 hours per week with comprehensive benefits.