Data Quality Auditor

Job not on LinkedIn

🔥 2 minutes ago

🏈 Alabama, Idaho, +26 more states – Remote

🏈 Alabama – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦬 Montana – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

🔎 Auditor

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Perform audit and abstraction of medical records from providers and/or vendors • Identify and submit appropriate, accurate, and clinically supported ICD codes to CMS for risk adjustment processes • Support coding judgments and decisions using industry-standard evidence and tools • Abstract and assign accurate medical codes for diagnoses documented by physicians and other qualified healthcare providers in office and/or facility settings • Apply coding guidelines and regulations, including requirements for establishing medical necessity • Identify clinically active versus historical conditions • Use medical records to verify documentation supporting disease etiology and manifestations • Meet stringent timelines aligned with project deadlines and directives • Conduct self-process audits for compliance with internal policies, procedures, and regulatory guidance from CMS, OIG, and other regulatory bodies

🎯 Requirements

• Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required • Computer proficiency including Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, and industry standard coding applications) • Experience with International Classification of Disease (ICD) codes required • CRC (Certified Risk Adjustment Coder) preferred • Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred • AA/AS or equivalent experience • Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on-the-job experience equal to approximately 1–2 years for CPC

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay range • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility