Certified Professional Coder & Medical Records Auditor

Hispanic Alliance for Career Enhancement; Utah; Hybrid; USD 43,888 - 93,574; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform comprehensive medical record audits for the Special Investigations Unit (SIU). The role focuses on ensuring CPT/HCPCS compliance and proper documentation across medical and behavioral health records.

The ideal candidate has 3+ years in medical coding or auditing, CPC certification, and strong analytical and communication skills. This is a full-time on-site position with a comprehensive benefits package.

Qualifications

• AAPC CPC Certification is required.
• 3+ years in medical coding or documentation auditing.
• Knowledge of CPT, HCPCS, ICD-10, CMS 1500 and UB04 elements.
• Experience researching coding and policies.
• Proficient with Excel and Word.

Responsibilities

• Conduct comprehensive medical record audits to ensure CPT/HCPCS or modifiers billed align with documentation.
• Provide detailed written summaries of audit findings.
• Explain findings to investigators, Medicaid leadership, law enforcement, and regulators.
• Research and apply state or CMS guidelines related to audits with minimal support.
• Identify potential billing errors, abuse, and fraud and discuss cases with Medical Directors.

Skills

Attention to detail

Strong communication

Analytical skills

Researching coding policies

Education

GED or equivalent

AAPC CPC Certification

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform comprehensive medical record audits for the Special Investigations Unit (SIU). The role focuses on ensuring CPT/HCPCS compliance and proper documentation across medical and behavioral health records.

The ideal candidate has 3+ years in medical coding or auditing, CPC certification, and strong analytical and communication skills. This is a full-time on-site position with a comprehensive benefits package.