CPC Billing Auditor - SIU & Behavioral Health

CVS Health Corporation; Jackson (MS); In loco; USD 44.000 - 94.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical coverage

Dental coverage

Vision coverage

Retirement savings options

Descrizione del lavoro

CVS Health Corporation is seeking a Certified Professional Coder (CPC) to conduct medical claim reviews within the Special Investigations Unit (SIU). The role requires interpreting CPT/HCPCS/Revenue Codes and ensuring documentation aligns with billing guidelines.

Responsibilities include comprehensive record reviews, detailed written summaries, and presenting findings to investigators, leadership, and regulators. Travel may be required to support reviews and audits across states.

Competenze

• Must have EHR/CMS coding knowledge and be able to interpret CPT/HCPCS/Revenue Codes.
• Minimum of 3 years in medical and/or behavioral health coding with 1–2 years in current professional coding and record review.
• Ability to apply coding policies and communicate findings clearly to investigators and leadership.

Mansioni

• Conduct comprehensive medical record reviews to verify coding accuracy.
• Provide detailed written summaries of findings from reviews.
• Explain results to investigators, plan leadership, and regulators as needed.
• Research state or CMS guidelines to support decisions during reviews.
• Identify potential billing errors, abuse and fraud and assist in investigations.

Conoscenze

Medical coding

Auditing

Communication

Travel flexibility

Formazione

AAPC CPC Certification

GED or High School Diploma

Strumenti

Excel

Word

Descrizione del lavoro

CVS Health Corporation is seeking a Certified Professional Coder (CPC) to conduct medical claim reviews within the Special Investigations Unit (SIU). The role requires interpreting CPT/HCPCS/Revenue Codes and ensuring documentation aligns with billing guidelines.

Responsibilities include comprehensive record reviews, detailed written summaries, and presenting findings to investigators, leadership, and regulators. Travel may be required to support reviews and audits across states.