Healthcare Data Quality Auditor — Medical Records & Coding

CVS Health; Town of King (WI); On-site; USD 25,000 - 49,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

CVS Health is seeking a full-time Medical Records Auditor to perform audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment. The role requires CPC/CCS-P certification and experience with ICD coding, with strong attention to regulatory guidelines.

You will support coding judgments, ensure accuracy, and adhere to strict timelines while maintaining documentation quality and compliance across provider or vendor records.

Qualifications

• Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
• CPC or CCS-P certification required.
• Experience with ICD codes required.

Responsibilities

• Audit and abstract medical records to identify and submit ICD codes for CMS risk adjustment.
• Support coding judgments using industry-standard evidence and tools.
• Assign accurate medical codes for diagnoses documented by physicians.
• Ensure compliance with coding guidelines and regulatory requirements.
• Identify clinically active vs. historical conditions.
• Document etiology and manifestations of disease processes.
• Adhere to project deadlines and perform self-audits for compliance.

Skills

Medical record review

Coding knowledge

Auditing

MS Office

Education

AA/AS or equivalent

AAPC/AHIMA credential training

Tools

Microsoft Office

ICD coding software

Job description

CVS Health is seeking a full-time Medical Records Auditor to perform audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment. The role requires CPC/CCS-P certification and experience with ICD coding, with strong attention to regulatory guidelines.

You will support coding judgments, ensure accuracy, and adhere to strict timelines while maintaining documentation quality and compliance across provider or vendor records.