CrawlJobs Logo

Coding Data Quality Auditor, Analyst

https://www.cvshealth.com/ Logo

CVS Health

Location Icon

Location:
United States

Category Icon

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

21.10 - 44.99 USD / Hour

Job Description:

Responsible for performing quality inter-rater review audits of medical records coded by internal team 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.

Job Responsibility:

  • Perform quality inter-rater review audits of medical records coded by internal team
  • Ensure ICD-10 codes submitted to CMS for risk adjustment are appropriate, accurate, and supported
  • Support coding judgment using industry standard evidence and tools
  • Communicate evidence across stakeholders
  • Lead dispute resolution
  • Mentor and provide education to internal staff based on audit findings
  • Communicate audit process and results to appropriate departments and management
  • Conduct process audits to ensure compliance
  • Identify and recommend opportunities for process improvements
  • Work independently and in cross functional teams
  • Adhere to stringent timelines
  • Meet coding accuracy and production standards
  • Monitor own work to help ensure quality
  • Act in ethical manner as required under HIPAA
  • Serve as training resource and subject matter expert for ICD coding and documentation
  • Apply AHA Coding Clinic guidance
  • Remain current on educational training and requirements
  • Perform other related duties as required

Requirements:

  • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
  • Experience with International Classification of Disease (ICD) codes required
  • Minimum of 3 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
  • Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications)
  • BA/BS 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 3 years for CPC
  • 5-8 years encompassing additional credentials and/or application of credentials

Nice to have:

  • 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
What we offer:
  • Affordable medical plan options
  • 401(k) plan with matching company contributions
  • Employee stock purchase plan
  • No-cost wellness screenings
  • No-cost tobacco cessation programs
  • No-cost weight management programs
  • Confidential counseling
  • Financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
March 04, 2026

Expiration:
March 27, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Coding Data Quality Auditor, Analyst

New

Analyst, Coding Data Quality Auditor

We’re building a world of health around every individual — shaping a more connec...
Location
Location
United States
Salary
Salary:
21.10 - 44.99 USD / Hour
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
March 13, 2026
Flip Icon
Requirements
Requirements
  • 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
  • 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
  • Bachelor of Arts/ Bachelor of Science Degree 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 3 years for CPC
  • 5-8 years encompassing additional credentials and/or application of credentials
Job Responsibility
Job Responsibility
  • 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
  • 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
  • Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations
  • Ability to work independently as well as in a cross functional role within other teams for collaboration on best practices
  • Possesses a genuine interest in improving and promoting quality
  • demonstrates accuracy and thoroughness and assists others to achieve the same through mentoring and instruction
  • 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
What we offer
What we offer
  • Affordable medical plan options
  • a 401(k) plan (including matching company contributions)
  • an employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
  • Fulltime
!
Read More
Arrow Right
New

Senior Analyst, Corporate IT SOX Audit

We’re building a world of health around every individual — shaping a more connec...
Location
Location
United States
Salary
Salary:
46988.00 - 122400.00 USD / Year
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
March 14, 2026
Flip Icon
Requirements
Requirements
  • 2+ years’ experience in IT SOX Audit, IT SOX Compliance, Control Validation, Risk Assessment, or Risk Consultant role
  • Ability to travel up to 10%
  • Must be willing to work 8:00am-5:00pm EDT or CDT
  • Bachelor's Degree or equivalent experience (HS diploma + 4 years relevant experience)
Job Responsibility
Job Responsibility
  • Effectively perform and document IT SOX audit activities in accordance with professional standards and the organization’s audit methodology
  • Execute testing and create work paper documentation
  • Understand procedures, results and business impacts
  • and document and express such understanding in both written and verbal form
  • Perform detailed review testing to analyze and validate information and provide constructive feedback to preparers to enhance the quality of testing work papers
  • Demonstrate the ability to accurately document ITGC process workflows and data flows
  • Create clear and accurate documentation and workflows of technology processes and test results and exceptions
  • Work in a fast-paced, collaborative setting with cross-functional teams
  • Lead individual project components and testing areas
  • oversee the work of more junior auditors and/or interns
What we offer
What we offer
  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
  • Fulltime
!
Read More
Arrow Right
New

Accounting Team Lead

We are seeking a highly motivated and detail-oriented Accounting Team Lead to jo...
Location
Location
India , Hyderabad
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
August 23, 2026
Flip Icon
Requirements
Requirements
  • Bachelor’s degree in Accounting (preferably B.Com)
  • Minimum of 8+ years of experience in Finance & Accounting
  • Highly proficient in use of Microsoft Excel (advanced or above advanced expertise)
  • Demonstrated proficiency with JD Edwards (JDE) and Tagetik is preferred
  • Prior experience or strong familiarity with Workday Financials or similar cloud-based ERP systems (SAP, Oracle, etc.)
  • Team lead experience with the ability to motivate team members and drive required outcomes
  • Excellent knowledge and understanding of IFRS
  • Fluency in English (written and spoken) is required
  • Highly proficient in Microsoft Excel (pivot tables, VLOOKUPs, data analysis)
  • Prior exposure in managing month end closing and reporting
Job Responsibility
Job Responsibility
  • Self-Starter and ability to work independently on day-to-day accounting operations, including accounts payable, accounts receivable, general ledger postings, and bank reconciliations
  • Ensure accurate and timely monthly, quarterly, and annual closing processes for the Netherlands entity, adhering to local GAAP and corporate reporting requirements (IFRS/GAAP, if applicable)
  • Prepare and post journal entries, ensuring proper classification and documentation
  • Perform intercompany reconciliation and settlement processes
  • Assist with the preparation of local statutory financial statements and tax filings (VAT, corporate income tax support) in coordination with external advisors
  • Conduct financial analysis and variance explanations as required by management
  • Reconcile balance sheet accounts and provide explanations of changes to prior periods
  • Prepare month end journal entries (accruals)
  • Analyze P&L to answer questions related to P&L
  • Perform special analysis when needed for the director or managers
Read More
Arrow Right
New

Accounts Payable Specialist

Accounts Payable (AP) function to support ongoing operational requirements and w...
Location
Location
India , Gurugram
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
April 20, 2026
Flip Icon
Requirements
Requirements
  • 2–4 years of experience in Accounts Payable
  • Commerce Graduate
  • End-to-end Accounts Payable processing
  • Hands-on experience with SAP HANA
  • Good working knowledge of TDS and GST
  • General accounting, invoice processing, vendor reconciliation
  • Month-end closing support and coordination
Job Responsibility
Job Responsibility
  • Accounts Payable (AP) function to support ongoing operational requirements and workload
Read More
Arrow Right
New

Account analyst

The role supports commercial and financial decision-making by providing accurate...
Location
Location
India , Powai IIT
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
April 17, 2026
Flip Icon
Requirements
Requirements
  • Graduate degree in Accounting (B.com or equivalent)
  • Minimum 1 year of hands-on experience in end-to-end PTP process, including Invoice Processing, Vendor reconciliation, Payment runs, PTP KPI’s, Reports
  • Experience with ERP or non-ERP systems
  • Proficient in MS Office (Excel, Power Point, Word)
Job Responsibility
Job Responsibility
  • Support order approval processes through detailed margin and price analysis, ensuring compliance with the Approved Authority Matrix (AAM)
  • Conduct operating expense (Opex) analysis to identify key cost drivers
  • Assist in budgeting and forecasting cycles, ensuring accuracy, completeness
  • Perform monthly margin variance analysis to evaluate financial performance, identify
Read More
Arrow Right
New

Financial analyst

The role supports commercial and financial decision-making by providing accurate...
Location
Location
India , Powai IIT
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
April 24, 2026
Flip Icon
Requirements
Requirements
  • Graduate degree in Accounting (B.com or equivalent)
  • Minimum 1 year of hands-on experience in end-to-end PTP process, including Invoice Processing, Vendor reconciliation, Payment runs, PTP KPI’s, Reports
  • Experience with ERP or non-ERP systems
  • Proficient in MS Office (Excel, Power Point, Word)
Job Responsibility
Job Responsibility
  • Support commercial and financial decision-making by providing accurate financial analysis, reporting, and insights
  • Work closely with business partners, sales teams, and finance stakeholders to ensure pricing discipline, cost control, and strong financial governance
  • Support order approval processes through detailed margin and price analysis, ensuring compliance with the Approved Authority Matrix (AAM)
  • Conduct operating expense (Opex) analysis to identify key cost drivers
  • Assist in budgeting and forecasting cycles, ensuring accuracy, completeness
  • Perform monthly margin variance analysis to evaluate financial performance, identify
Read More
Arrow Right
New

Site Supervisor

The Site Supervisor will be responsible for overseeing daily on-site activities ...
Location
Location
India , Mundra
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
April 25, 2026
Flip Icon
Requirements
Requirements
  • Diploma in Mechanical Engineering (mandatory)
  • 2–5 years of site supervision experience in EPC/piping/ETP/industrial projects
  • Hands-on knowledge of thermoplastic piping systems (HDPE/PPH/PVDF) preferred
  • Basic knowledge of QA/QC procedures, welding, and site safety standards
  • Proficiency in MS Excel/Word for reporting
Job Responsibility
Job Responsibility
  • Supervise installation, welding (butt fusion/electrofusion), and erection of HDPE/PPH/PVDF piping
  • Monitor contractors and technicians to ensure work is executed as per drawings and quality standards
  • Coordinate site logistics, manpower allocation, and daily work planning
  • Ensure adherence to QA/QC procedures, safety protocols, and ISO norms
  • Conduct visual inspections of welds, fittings, and installations before client/QA approvals
  • Support QA/QC engineers in conducting tests and maintaining weld logs
  • Maintain Daily Progress Reports (DPRs), site records, and manpower logs
  • Report site issues, bottlenecks, and resource requirements to Project Engineers/Managers
  • Support in preparing documentation for client handovers
  • Act as the point of contact for site teams, contractors, and Engineers
  • Fulltime
Read More
Arrow Right
New

Finance Control Consultant

In this position, you will be a member of the To India team and be part of the l...
Location
Location
India , Bangalore
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
April 20, 2026
Flip Icon
Requirements
Requirements
  • Degree in Accounting/Finance, or related field
  • MBA or CA Interns
  • 2 ~ 5 years of relevant experience
  • Strong understanding of GAAP, corporate finance, accounting, taxation, manufacturing process flow, Supply Chain costing principles—understands P&L and balance sheet dynamics
  • Strong working knowledge on Office365, Power Query, Power BI & Power Apps is preferred
  • High on Integrity and Strong Ethics
Job Responsibility
Job Responsibility
  • Financial stability – Secure a stable base to understand the overall financial performance
  • Support closing, SCS, Estimates process, secure handover with business control network
  • Analytical capability – Utilize knowledge of visualization tools such as Power BI, Qlik, bridges to explore & explain financial data in an efficient way
  • Story telling – Analyze the complex data and make it into something actionable
  • Collaborate with other controllers and cross-functionally to drive optimization and achieve financial goals
  • Oversee the financial reporting processes and ensure compliance with accounting standards, regulatory requirements, and internal policies
  • Prepare and review financial statements, manage audits, and communicate financial performance to management and stakeholders
  • Monthly reports & analysis, providing recommendations from financial perspective on operational issues
  • Conduct the monthly closing process, including the consolidation of Arrow entities, and financial statement preparation to meet required deadlines
  • Strong interpersonal skills, with the ability to influence others, willingness to learn and share knowledge
Read More
Arrow Right