Medical Coding Data Quality Auditor

CVS Health; Montana City (MT); On-site; USD 25,000 - 49,000; Full time

Job summary

CVS Health is seeking a dedicated coder/auditor to perform audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment. You will ensure accuracy and compliance with state and federal regulations and internal policies, supporting coding judgment with industry-standard tools.

The role requires at least 1 year of related experience, CPC or CCS-P certification, and proficiency with ICD codes and Microsoft Office.

Qualifications

• 1 year of recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
• CPC or CCS-P required.
• Proficiency with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook) and industry standard coding applications.
• Experience with ICD codes required.

Responsibilities

• Audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment.
• Support coding judgment using industry standard evidence and tools.
• Assign diagnoses accurately as documented by physicians and other providers.
• Identify clinically active vs. historical conditions.
• Ensure codes are supported by clinical documentation and regulations.
• Use medical records to document etiology and manifestations of disease processes.
• Meet strict timelines aligned with project deadlines and directives.
• Conduct self-audit to ensure compliance with internal policies and regulatory guidance.

Skills

ICD coding

Education

AA/AS or equivalent experience

AAPC/AHIMA CPC/CCS-P training

Tools

Microsoft Office

coding applications

Job description

CVS Health is seeking a dedicated coder/auditor to perform audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment. You will ensure accuracy and compliance with state and federal regulations and internal policies, supporting coding judgment with industry-standard tools.

The role requires at least 1 year of related experience, CPC or CCS-P certification, and proficiency with ICD codes and Microsoft Office.