Data Quality Auditor Analyst
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Job Description
Quality Auditor performing audits on medical records for CVS Health. Ensuring accuracy of ICD codes and providing education based on audit findings.
Responsibilities:
- Perform second level quality inter-rater review audits of medical records coded by internal team and external vendor if applicable
- Ensure ICD codes submitted to CMS are appropriate, accurate, and supported by clinical documentation
- Act as mentor to provide education to internal staff based on audit findings
- Conduct process audits to ensure compliance with internal policies and procedures
- Work independently and collaboratively with other teams
Requirements:
- Minimum of 3 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
- Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P)
- CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required
- CRC (Certified Risk Adjustment Coder) required within the first six months
- CPMA (Certified Professional Medical Auditor), CDEO (Certified Documentation Expert Outpatient) or CPC-I (Certified Professional Coding Instructor) preferred
- Excellent analytical and problem-solving skills
- Superior communication, organizational, and interpersonal skills
Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost wellness screenings, tobacco cessation and weight management programs
- Confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
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