Medical Records Coding & Quality Auditor

Internationalinsuranceprofessionals; South Carolina; Sur place; USD 26 000 - 54 000; Plein temps

Avantages offerts par ce poste

Medical, dental and vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health is seeking a Medical Records Auditor to abstract provider and vendor records and assign CMS ICD codes for risk adjustment. You will ensure codes are accurate and compliant with state and federal regulations and policies.

Responsibilities include supporting coding judgments, identifying active vs historical conditions, meeting deadlines, and maintaining HIPAA/privacy standards while communicating with providers and using standard coding tools and Microsoft Office.

Qualifications

• CPC or CCS-P certification required.
• Experience with ICD coding and medical record review.
• Proficient in Microsoft Office and coding applications.
• Ability to contact providers to retrieve records for audits.
• Knowledge of coding guidelines and HIPAA/privacy rules.

Responsabilités

• Audit and abstract provider/vendor medical records to identify CMS ICD codes.
• Validate codes for risk adjustment accuracy and regulatory compliance.
• Support coding judgments using standard evidence and tools.
• Identify active vs historical conditions and ensure documentation supports etiology.
• Maintain timelines and conduct self-audits for compliance.

Connaissances

CPC / CCS-P

Microsoft Office

Outbound calls

ICD coding

Medical records review

Formation

AA/AS or equivalent

CPC/CCS-P training completion

Outils

Coding applications

Microsoft Office suite

Description du poste

CVS Health is seeking a Medical Records Auditor to abstract provider and vendor records and assign CMS ICD codes for risk adjustment. You will ensure codes are accurate and compliant with state and federal regulations and policies.

Responsibilities include supporting coding judgments, identifying active vs historical conditions, meeting deadlines, and maintaining HIPAA/privacy standards while communicating with providers and using standard coding tools and Microsoft Office.