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Clinical Documentation Auditor

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States

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Category:
Health and Beauty

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Contract Type:
Employment contract

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Salary:

21.10 - 36.78 USD / Hour

Job Description:

The Clinical Documentation Auditor is a vital member of the Population Health Clinical Documentation auditing team at Oak Street Health. S/he champions the organization's mission to provide high quality patient care by providing measurable, actionable feedback to providers that will result in improved documentation accuracy and coding practice. The role will collaborate with providers, coders, payers, and a variety of internal and external personnel on a wide scope of Clinical Documentation Auditing education efforts.

Job Responsibility:

  • Comprehensively review outpatient provider notes for accuracy and completeness
  • Synthesize coding correction opportunities for ongoing provider education
  • Achieve 90%+ audit results on coding correction accuracy and less than 25% on missed coding correction opportunities
  • Review on average a minimum of 20 provider notes per day
  • Maintain and grow knowledge of Medicare and Commercial Risk Adjustment outpatient/inpatient billing systems/processes
  • Identify trends and training opportunities to support clinical documentation accuracy improvement
  • Champion Coding Corrections standards and drive integration into Canopy tools and ongoing Care Team processes
  • Other duties as assigned

Requirements:

  • At least 3 years of experience in Medicare risk adjustment coding
  • At least 3 years of experience in assigning/auditing ICD-10 CM codes to outpatient records
  • Ability to succeed in a fast-paced, ever-changing environment
  • Self-starter with high degree of drive, initiative, and follow through
  • Expert in accurate and specific documentation
  • Strong communication skills
  • A flexible and positive attitude
  • Strong computer skills and basic knowledge of Microsoft Excel
  • Ability to work independently with minimum supervision, excellent reliability, and a positive attitude
  • CRC ('Certified Risk Coder') credential is required
  • RN or LPN certification preferred
  • US work authorization

Nice to have:

RN or LPN certification preferred

What we offer:
  • Collaborative and energetic culture
  • High levels of responsibility and rapid advancement
  • Competitive benefits, including paid vacation/sick time, generous 401K match with immediate vesting, as well as health benefits
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs including 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

Additional Information:

Job Posted:
May 13, 2025

Expiration:
October 10, 2025

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