Certified Professional Coder - Investigations & Auditing

DaMar Staffing; Indianapolis (IN); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Comprehensive benefits

Paid time off

Wellness programs

Retirement options

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to review medical records and ensure coding accuracy across multiple payer types. The role emphasizes meticulous documentation, adherence to CPT/HCPCS guidelines, and clear communication of findings to diverse stakeholders.

Candidates should have 3+ years of coding or auditing experience, a CPC certification, and strong Excel skills. Travel for meetings and potential testimony may be required.

Qualifications

• AAPC CPC certification required.
• 3+ years of medical coding or documentation auditing experience.
• Knowledge of CPT, HCPCS, Revenue Codes, CMS 1500/UB04 data elements.

Responsibilities

• Perform comprehensive medical record reviews to ensure billing aligns with records.
• Provide detailed written summaries of review findings.
• Articulate findings to investigators, leadership, and regulators as needed.
• Discuss cases with Medical Directors to validate decisions.
• Identify billing errors, abuse, and fraud and opportunities for savings.

Skills

CPC coding

Medical coding

Excel

Education

GED or equivalent

AAPC CPC Certification

Tools

Microsoft Excel

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to review medical records and ensure coding accuracy across multiple payer types. The role emphasizes meticulous documentation, adherence to CPT/HCPCS guidelines, and clear communication of findings to diverse stakeholders.

Candidates should have 3+ years of coding or auditing experience, a CPC certification, and strong Excel skills. Travel for meetings and potential testimony may be required.