Medical Coding & Data Quality Auditor

CVS Health; Montgomery (AL); On-site; USD 25,000 - 49,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits

Full-time position

Job summary

CVS Health is seeking a Medical Records Auditor/Abstractor to review provider and vendor records, assign ICD codes, and ensure CMS risk adjustment submissions are accurate and compliant with state and federal regulations. The role supports coding judgments with industry-standard evidence and robust documentation.

Responsibilities include abstraction of diagnoses, identifying active vs historical conditions, meeting tight deadlines, and conducting internal audits to ensure policy adherence.

Qualifications

• Minimum of 1 year recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.
• CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required.
• Experience with ICD codes and regulatory guidelines.

Responsibilities

• Audit and abstract medical records to identify and submit ICD codes for CMS risk adjustment.
• Ensure codes are accurate, supported by documentation, and compliant with state/federal regulations.
• Identify active vs historical conditions and ensure clinical justification for etiology and manifestations.
• Meet tight project deadlines and conduct internal/process audits for compliance.

Skills

Medical record review

Coding & auditing

MS Office proficiency

ICD coding experience

Education

AA/AS or equivalent

AAPC/AHIMA credential training CPC/CCS-P

Tools

Coding software

Job description

CVS Health is seeking a Medical Records Auditor/Abstractor to review provider and vendor records, assign ICD codes, and ensure CMS risk adjustment submissions are accurate and compliant with state and federal regulations. The role supports coding judgments with industry-standard evidence and robust documentation.

Responsibilities include abstraction of diagnoses, identifying active vs historical conditions, meeting tight deadlines, and conducting internal audits to ensure policy adherence.