{"id":3119798,"url":"https://alion.io/job/cvs-health-coding-data-quality-audit-analyst","title":"Coding Data Quality Audit Analyst","company":{"id":4223,"name":"CVS Health","domain":"cvshealth.com","url":"https://alion.io/company/cvshealth","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":null},"role":"Operations","role_family":"Operations","seniority":"middle","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":58000,"max_usd":115000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":169},"experience_years_min":3,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-10-21T00:00:00Z","employer_posted_date":"2026-10-21","last_verified_at":"2026-10-24T00:47:30Z","board_verified":true,"closed_at":null,"days_open":3,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":3},"description":"We’re building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.\nPosition Summary\nThe Coding Data Quality Audit Analyst is responsible for performing second-level quality inter-rater review audits of medical records coded by internal teams, as well as external vendors (if applicable), to ensure that ICD codes submitted to the Centers for Medicare & Medicaid Services (CMS) for risk adjustment purposes are appropriate, accurate, and supported by clinical documentation in accordance with all state and federal regulations, as well as internal policies and procedures.\nJob Responsibilities\nDemonstrates the ability to support coding judgments and decisions using industry-standard evidence and tools.\nConfidently communicates supporting evidence to internal stakeholders with varying levels of coding and clinical expertise through both written and verbal communication, including interactions with clinical staff, coding staff, federal regulators, and vendor coding resources.\nActs as a mentor by providing education to internal staff based on audit findings and offers general education on ICD coding, as appropriate.\nConducts process audits to ensure compliance with internal policies, procedures, CMS regulations, and guidance from the Office of Inspector General (OIG) and other regulatory bodies.\nDemonstrates the ability to work independently and collaboratively across cross-functional teams to promote best practices.\nAdheres to stringent timelines and project deadlines.\nDemonstrates a genuine commitment to quality improvement, accuracy, and thoroughness while assisting others in achieving the same through mentorship and instruction.\nMaintains thorough knowledge of coding guidelines and regulations to ensure compliance requirements are met, including the establishment of medical necessity.\nIdentifies and communicates documentation deficiencies to support ongoing education and development opportunities for peers.\nMaintains extensive knowledge of medical documentation requirements, fraud and abuse regulations, and penalties associated with documentation and coding violations based on governmental guidelines.\nRequired Qualifications\nCPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) certification required.\nMinimum of 3 years of recent, related experience in medical record documentation review, diagnosis coding, and/or auditing.\nCompletion of an AAPC or AHIMA training program for a core credential (CPC or CCS-P), with associated work history and on-the-job experience equivalent to approximately 3 years for CPC certification.\nPreferred Qualifications\nCRC (Certified Risk Adjustment Coder) required within the first six months.\nEducation\n Associate degree, or equivalent experience preferred.\nAnticipated Weekly Hours\n40Time Type\nFull timePay Range\nThe typical pay range for this role is:\n$21.10 - $44.99This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. \nOur people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.\nGreat benefits for great people\nWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.\nThis full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on Benefits Moments.\nWe anticipate the application window for this opening will close on: 10/30/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.","description_format":"text","description_chars":4747,"description_truncated":false,"requirements":{"experience_years_min":3,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"associate","optional":false},"security_clearance":false,"languages":[]},"benefits":["Wellness"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Primary Care & Medical Centers","Pharmacies","Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-10-22T23:56:59Z"}],"visa":[],"liveness":{"score":77,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.854,"p_room":0.9,"age_days":2,"expected_fill_days":4,"reasons":["conf:0","velocity","win:mid","comp:brand"],"computed_at":"2026-10-23T05:54:15Z"},"pay":null,"html_url":"https://alion.io/job/cvs-health-coding-data-quality-audit-analyst","json_url":"https://alion.io/job/cvs-health-coding-data-quality-audit-analyst.json","meta":{"generated_at":"2026-10-24T02:35:41Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":4209,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-25T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":4223},"rest":"https://alion.io/mcp/rest/get_company?id=4223"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fcvs-health-coding-data-quality-audit-analyst"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fcvs-health-coding-data-quality-audit-analyst"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fcvs-health-coding-data-quality-audit-analyst"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/cvs-health-coding-data-quality-audit-analyst\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fcvs-health-coding-data-quality-audit-analyst"}]}