Certified Medical Coding Analyst

CVS Health Corporation; Columbus (OH); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health Corporation seeks a Certified Coding Analyst to perform medical claim reviews, audit records, and ensure coding accuracy across CPT/HCPCS, ICD-10, and modifiers. The role involves applying CMS/state guidelines, collaborating with Medical Directors, and identifying potential billing issues to support compliant reimbursement.

Ideal candidates have CPC certification, 2+ years in coding/auditing, and strong Excel/Word proficiency, with excellent attention to detail and communication

Qualifications

• AAPC CPC certification and 2+ years in medical coding, claims review, or auditing.
• Strong knowledge of CPT, HCPCS, ICD-10 and modifiers.
• Experience with CMS 1500 and UB04 data elements.
• Proficiency with Excel and Word.
• Excellent attention to detail and clear written/verbal communication.

Responsibilities

• Conduct comprehensive medical record audits to verify CPT/HCPCS codes align with documentation.
• Research and apply CMS and state guidelines to coding reviews.
• Review cases with Medical Directors to validate decisions.
• Identify and investigate potential billing errors, fraud, or abuse.
• Prepare concise findings and present outcomes to internal partners.
• Maintain records and track recurring coding issues for process improvements.

Skills

Medical coding

Auditing

Attention to detail

Communication skills

Education

AAPC CPC Certification

High School diploma or GED

Tools

Excel

Word

Encoder Pro

Job description

CVS Health Corporation seeks a Certified Coding Analyst to perform medical claim reviews, audit records, and ensure coding accuracy across CPT/HCPCS, ICD-10, and modifiers. The role involves applying CMS/state guidelines, collaborating with Medical Directors, and identifying potential billing issues to support compliant reimbursement.

Ideal candidates have CPC certification, 2+ years in coding/auditing, and strong Excel/Word proficiency, with excellent attention to detail and communication