ICD Coding & Medical Records Data Quality Auditor

CVS Health; South Dakota Park (SD); On-site; USD 25,000 - 49,000; Full time

Job summary

CVS Health is seeking a full-time Medical Records Auditor to review and abstract medical records, ensure accurate ICD coding, and support CMS risk adjustment processes. You will work with physician and provider documentation to verify medical necessity and maintain regulatory compliance.

The role requires CPC/CCS-P credentials, at least 1 year of relevant experience, and proficiency with Microsoft Office. Competitive benefits and a comprehensive compensation package accompany this position.

Qualifications

• 1 year of 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.
• Proficiency with Microsoft Office applications.

Responsibilities

• Audit and abstract medical records to identify and submit ICD codes for CMS risk adjustment.
• Support coding judgment using industry-standard evidence and tools.
• Abstract and assign accurate medical codes for diagnoses documented by clinicians.
• Know and apply coding guidelines to meet compliance requirements (medical necessity).
• Identify clinically active vs historical conditions and ensure clinical documentation supports codes.
• Utilize records to support etiology and manifestations of diseases.
• Meet project deadlines with timely audits and reviews.
• Conduct self-audit to ensure compliance with policies and regulatory guidance.

Skills

Medical record auditing

Attention to detail

Time management

Education

AA/AS or equivalent experience

AAPC/AHIMA CPC/CCS-P credential training

Tools

Microsoft Word

Excel

Access

PowerPoint

Outlook

Job description

CVS Health is seeking a full-time Medical Records Auditor to review and abstract medical records, ensure accurate ICD coding, and support CMS risk adjustment processes. You will work with physician and provider documentation to verify medical necessity and maintain regulatory compliance.

The role requires CPC/CCS-P credentials, at least 1 year of relevant experience, and proficiency with Microsoft Office. Competitive benefits and a comprehensive compensation package accompany this position.