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Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Analyst, Coding Data Quality Auditor - **Company:** CVS Health - **Location:** United States - **Experience:** Expert - **Salary:** $43,888.0 - $93,579.0 - **Contract:** Permanent contract - **Skills:** Microsoft Access, Microsoft Word, Microsoft Excel, Microsoft Outlook, Computer Literacy, Microsoft Office, Microsoft PowerPoint - **Published:** August 20, 2026 - **Apply:** https://www.juju.com/job/00000000go0acd ## About the Role + Ability to work independently as well as in a cross functional role within other teams for collaboration on best practices. + Adhere to stringent timelines consistent with project deadlines and directives. + Must possess high level of dependability and is able to meet coding accuracy and production standards. + Monitors own work to help ensure quality. + Required to act in ethical manner at all times as required under HIPAA's Privacy and Security rules to handle patient data with uncompromised adherence to the law. + Possesses a genuine interest in improving and promoting quality; demonstrates accuracy and thoroughness and assists others to achieve the same through mentoring and instruction. + Medical record auditing skills and abstraction expertise., + Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications). + Experience with International Classification of Disease (ICD) codes required. + Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required. + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) AND CRC (Certified Risk Adjustment Coder) required Preferred Qualifications + 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 Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 3 years for CPC., + BA/BS or equivalent experience. ## Description Responsible for performing quality inter-rater review audits of medical records coded by internal team (CDQA and Sr CDQA) to ensure the ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. In this position you will have the opportunity to demonstrate proficiency in the following: + Proven ability to support coding judgment and decisions using industry standard evidence and tools. + Ability to confidently speak to such evidence across stakeholders with varying knowledge and clinical expertise in either written or verbal forms including communication with clinical or coding staff, federal regulators and vendor coding resources. + Leads dispute resolution. + Acts as mentor to provide education to internal staff based on audit findings; provides general education on ICD codes as appropriate. + Effectively communicates the audit process and results to appropriate departments and management. + Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations. + Identifies and recommends opportunities for process improvements so that productivity and quality goals can be met or exceeded and operational efficiency and final accuracy is achieved., + Serves as the training resource and subject matter expert to vendors, providers and other team members for questions regarding ICD coding and documentation requirements. + Conducts process audits to ensure compliance with internal policies and procedures as well as regulatory guidance from CMS, OIG or other Regulatory body. + Expertise in assigning accurate medical codes for diagnoses as documented for physicians and other qualified healthcare providers in the office and/or facility setting. + Thorough knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity. + In depth knowledge of medical terminology and anatomy for all body systems + Understand the audit process for risk adjustment models. + Identify and communicate documentation deficiencies to allow for continuous education opportunities for providers, vendors and peers. + Expertise in medical documentation, fraud, abuse and penalties for documentation and coding violations based on governmental guidelines. + Apply AHA Coding Clinic guidance to identify and resolve coding issues. + Remains current on educational training and requirements including ICD coding, CMS documentation requirements, and State and Federal regulations. + Performs other related duties as required ## Related Videos - [ZEISS & Microsoft - Building the Next Generation Medical Ecosystem in the Cloud](https://www.wearedevelopers.com/videos/424-zeiss-microsoft-building-the-next-generation-medical-ecosystem-in-the-cloud) - [Blazing Accessibility Basics](https://www.wearedevelopers.com/videos/568-blazing-accessibility-basics) - [In-depth .NET Azure Functions: Isolated mode, performance and durable AI agents](https://www.wearedevelopers.com/videos/100207-in-depth-net-azure-functions-isolated-mode-performance-and-durable-ai-agents) - [Developing the Rich Text Editor for DeepL.com](https://www.wearedevelopers.com/videos/1172-developing-the-rich-text-editor-for-deepl-com) - [From Bedside Beeps to Interoperable Bytes – Getting your medical devices ready to talk the IEEE 11073 language](https://www.wearedevelopers.com/videos/771-from-bedside-beeps-to-interoperable-bytes-getting-your-medical-devices-ready-to-talk-the-ieee-11073-language) - [WeAreDevelopers LIVE - Gaps in CSS, EU Accessibility Act and more!](https://www.wearedevelopers.com/videos/1314-wearedevelopers-live-gaps-in-css-eu-accessibility-act-and-more) ## Related Articles - [Data Analyst Salary in the UK](https://www.wearedevelopers.com/magazine/278-data-analyst-salary-in-the-uk) - [Quick guide: How to write a Software Developer CV](https://www.wearedevelopers.com/magazine/37-quick-guide-how-to-write-a-software-developer-cv) - [Should senior developers refuse interview coding challenges?](https://www.wearedevelopers.com/magazine/29-should-senior-developers-refuse-interview-coding-challenges) - [Best Coding Boot Camps in Germany](https://www.wearedevelopers.com/magazine/237-best-coding-boot-camps-in-germany) - [What Are The Top Skills Required For Azure Developers?](https://www.wearedevelopers.com/magazine/77-what-are-the-top-skills-required-for-azure-developers) - [Can coding be the next blue collar career?](https://www.wearedevelopers.com/magazine/44-can-coding-be-the-next-blue-collar-career)