Medical Records Coding & Data Quality Auditor

CVS Health; Elm (PA); On-site; USD 25,000 - 49,000; Full time

Job summary

CVS Health is seeking a detail‑oriented Medical Records Auditor to perform audits and abstraction of medical records for accurate CMS risk adjustment coding. You will support coding decisions with evidence, ensuring medical necessity and regulatory compliance in a fast-paced environment.

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

Qualifications

• 1 year or more experience in medical record documentation review, coding, and/or auditing.
• CPC or CCS-P certification required.
• Proficient with ICD coding and Microsoft Office applications.

Responsibilities

• Audit and abstraction of medical records to identify and submit CMS ICD codes for risk adjustment.
• Support coding judgments using evidence and industry-standard tools.
• Ensure codes are accurate, medically supported, and compliant with regulations.

Skills

Medical record review

ICD coding knowledge

Auditing experience

CPC/CCS-P certification

Education

AA/AS or equivalent experience

AAPC/AHIMA CPC/CCS-P training

Tools

MS Office

Job description

CVS Health is seeking a detail‑oriented Medical Records Auditor to perform audits and abstraction of medical records for accurate CMS risk adjustment coding. You will support coding decisions with evidence, ensuring medical necessity and regulatory compliance in a fast-paced environment.

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