Medical Records Coding Auditor: Risk Adjustment Compliance

Internationalinsuranceprofessionals; Connecticut; On-site; USD 25,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a skilled medical records coder to audit and abstract provider and vendor records for CMS codes. You will validate risk adjustment codes, ensure documentation supports diagnoses, and comply with state/federal regulations.

The role requires 1+ year of coding/audit experience and proficiency with ICD codes and office software. Excellent analytical and communication skills are essential, with strong attention to detail and the ability to meet tight deadlines.

Qualifications

• CPC or CCS-P certification required.
• Minimum 1 year experience in medical record documentation review, diagnosis coding, or auditing.
• Strong knowledge of ICD codes and coding guidelines.
• Experience with HIPAA privacy and security rules.

Responsibilities

• Audit and abstract provider or vendor medical records for CMS coding.
• Validate codes for risk adjustment accuracy and compliance with regulations.
• Support coding judgments using industry-standard evidence and tools.
• Identify active vs historical conditions and responsible documentation.
• Adhere to project timelines and internal policies; perform self-audits.

Skills

Coding judgement

Medical terminology

Regulatory compliance

Communication

Education

CPC or CCS-P certification

AA/AS or equivalent experience

AAPC/AHIMA training program completion

Tools

Microsoft Office

coding applications

Job description

CVS Health is seeking a skilled medical records coder to audit and abstract provider and vendor records for CMS codes. You will validate risk adjustment codes, ensure documentation supports diagnoses, and comply with state/federal regulations.

The role requires 1+ year of coding/audit experience and proficiency with ICD codes and office software. Excellent analytical and communication skills are essential, with strong attention to detail and the ability to meet tight deadlines.