Medical Records Coding & Data Quality Auditor

4062 Aetna Resources, LLC; Tennessee; Hybrid; USD 26,000 - 52,000; Full time

Benefits offered by this job

Medical insurance

Paid time off

Retirement plan

Wellness programs

Job summary

CVS Health is hiring for a role focusing on auditing and abstracting provider and vendor medical records to verify CMS ICD codes. You will validate codes used in risk adjustment, ensure documentation supports diagnoses, and adhere to strict regulatory guidelines.

The position requires CPC/CCS-P credentials, 1 year of related experience, and proficiency with ICD coding and Microsoft Office. Full-time, on-site in Tennessee with a comprehensive benefits package.

Qualifications

• CPC or CCS-P credential required.
• 1 year of related medical record review or coding experience.
• Experience with ICD coding and HIPAA compliance.

Responsibilities

• Audit and abstraction of provider/ vendor medical records for ICD codes.
• Validate risk adjustment codes for accuracy and documentation.
• Ensure compliance with CMS, OIG, and internal policies.
• Support coding judgments using industry evidence and tools.
• Maintain timelines and conduct self-audits for accuracy.
• Handle patient data per HIPAA and privacy rules.

Skills

ICD coding

Medical terminology

Auditing

Education

AA/AS or equivalent with CPC/CCS-P training

Tools

Microsoft Office

Job description

CVS Health is hiring for a role focusing on auditing and abstracting provider and vendor medical records to verify CMS ICD codes. You will validate codes used in risk adjustment, ensure documentation supports diagnoses, and adhere to strict regulatory guidelines.

The position requires CPC/CCS-P credentials, 1 year of related experience, and proficiency with ICD coding and Microsoft Office. Full-time, on-site in Tennessee with a comprehensive benefits package.