CPC Auditor for SIU & Coding Compliance

4062 Aetna Resources, LLC; Missouri; Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU) ensuring coding compliance across medical, behavioral, transportation, and other healthcare services.

The role requires 3+ years of medical coding or documentation auditing, CPC certification (AAPC), and strong knowledge of CPT/HCPCS, ICD-10, CMS 1500, UB04, with proficiency in Excel and Word. Full-time in Missouri, with comprehensive benefits.

Qualifications

• AAPC CPC Certification required and 3+ years of medical coding or documentation auditing experience.
• Knowledge of CPT, HCPCS, ICD-10, CMS 1500 and UB04 data elements.
• Experience with researching coding and policies; MS Office (Excel/Word) proficiency.

Responsibilities

• Perform medical claim reviews for the SIU to ensure coding compliance.
• Determine correct coding and documentation during medical record reviews.
• Ensure state, federal and company requirements are met and identify billing patterns.

Skills

CPC Certification

Medical coding

Policy research

Attention to detail

Education

AAPC CPC Certification

Tools

Excel

Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU) ensuring coding compliance across medical, behavioral, transportation, and other healthcare services.

The role requires 3+ years of medical coding or documentation auditing, CPC certification (AAPC), and strong knowledge of CPT/HCPCS, ICD-10, CMS 1500, UB04, with proficiency in Excel and Word. Full-time in Missouri, with comprehensive benefits.