Senior Medical Coding Quality Auditor

Internationalinsuranceprofessionals; Kansas; On-site; USD 29,000 - 62,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

CVS Health is seeking a Quality Inter-Rater Review Auditor to ensure ICD-10 codes used for CMS risk adjustment are accurate and well-supported by clinical documentation. You will audit medical records, mentor staff, and communicate findings to stakeholders while upholding HIPAA requirements.

The role emphasizes collaboration across teams, process improvement, and strict adherence to CMS guidelines to deliver high-quality coding and documentation.

Qualifications

• Computer proficiency with Word, Excel, Access, PowerPoint, Outlook and standard coding apps.
• Experience with ICD codes is required.
• Minimum 5 years of experience in medical record documentation review, diagnosis coding, and/or auditing.

Responsibilities

• Perform quality inter-rater audits of medical records and ICD coding.
• Ensure ICD-10 codes submitted to CMS are accurate and well-supported.
• Mentor staff and provide education on ICD coding.
• Communicate audit results to stakeholders and management.
• Identify opportunities for process improvements to meet quality goals.

Skills

Microsoft Office

ICD codes

Auditing

HIPAA compliance

Education

BA/BS or equivalent

CPC/CCS-P training

Tools

Coding applications

Job description

CVS Health is seeking a Quality Inter-Rater Review Auditor to ensure ICD-10 codes used for CMS risk adjustment are accurate and well-supported by clinical documentation. You will audit medical records, mentor staff, and communicate findings to stakeholders while upholding HIPAA requirements.

The role emphasizes collaboration across teams, process improvement, and strict adherence to CMS guidelines to deliver high-quality coding and documentation.