Senior ICD Coding & Medical Records Auditor

Internationalinsuranceprofessionals; Alabama; Hybrid; USD 29,000 - 61,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement plan

Job summary

CVS Health is seeking an experienced Quality Auditor for medical records coding and risk adjustment. You will lead inter-rater audits to ensure ICD-10 codes are accurate and well-supported by documentation.

Responsibilities include mentoring staff, presenting audit findings, and ensuring compliance with CMS, HIPAA, and internal policies. Strong communication with clinicians and regulators is essential.

Qualifications

• Proficient in ICD coding and medical record auditing.
• Knowledge of CMS regulations and HCC risk adjustment.
• Experience with HIPAA privacy and security requirements.

Responsibilities

• Perform quality inter-rater audits of medical records and validate CMS risk adjustment codes.
• Support coding judgments with industry evidence and documentation.
• Mentor staff and educate on ICD coding practices.
• Communicate audit results to CMS, providers, and internal stakeholders.
• Ensure compliance with CMS, OIG, and internal policies.

Skills

ICD coding

Medical records auditing

HIPAA compliance

Stakeholder communication

Mentoring

Education

BA/BS or equivalent

AAPC/AHIMA credential training (CPC/CCS-P/CRC)

Tools

Microsoft Office

Coding applications

Job description

CVS Health is seeking an experienced Quality Auditor for medical records coding and risk adjustment. You will lead inter-rater audits to ensure ICD-10 codes are accurate and well-supported by documentation.

Responsibilities include mentoring staff, presenting audit findings, and ensuring compliance with CMS, HIPAA, and internal policies. Strong communication with clinicians and regulators is essential.