Coding Data Quality Auditor

Clinical Careers Page(1 month ago)

ConnecticutOnsiteFull TimeMedior$37,000 - $77,640Clinical Coding / Risk Adjustment

About this role

This role performs quality inter-rater reviews of medical records to validate ICD-10 coding submitted for CMS risk adjustment and to ensure documentation is accurate and compliant with state and federal regulations. It sits within CVS Health's coding and clinical quality operations and serves as a subject matter resource on coding and documentation standards.

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Required Skills

Medical Coding
ICD-10
Risk Adjustment
Medical Auditing
Documentation Review
Process Auditing
Mentoring
Communication
Microsoft Excel
Analytical Skills

Qualifications

CPC
CCS-P
CRC (Obtain Within 1 Year)
AAPC/AHIMA Training Program Completion

About Clinical Careers Page

cvshealth.com

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.

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