CPC Certified Coding Auditor - Claims & Compliance

Oak St. Health; Indianapolis (IN); Vor Ort; USD 44.000 - 102.000; Vollzeit

Zusammenfassung

CVS Health is seeking a Certified Coding Analyst to perform comprehensive medical record audits and ensure coding accuracy and compliance. You will research CPT/HCPCS guidelines, review documentation, and identify potential billing errors, explaining decisions clearly to internal partners.

The role requires CPC certification, 2+ years of coding/auditing experience, and strong knowledge of CPT/HCPCS/ICD-10. Proficiency with Excel and Word is expected, with the ability to communicate findings

Qualifikationen

• AAPC CPC certification and ongoing coding knowledge.
• 2+ years in medical coding, claims review, and auditing.
• Strong knowledge of CPT, HCPCS, ICD-10, modifiers and CMS 1500/UB04 elements.
• Proficiency with Microsoft Excel and Word; encoder tools experience.

Aufgaben

• Audit medical records to verify CPT/HCPCS and modifiers align with documentation.
• Apply state, CMS, and organizational guidelines to audits with minimal guidance.
• Review cases with Medical Directors to validate decisions.

Kenntnisse

CPC Certification

Medical coding

Auditing

CMS guidelines

Excel

Word

Ausbildung

Certified Professional Coder (CPC)

High School diploma

Tools

Excel

Word

Encoder Pro

Jobbeschreibung

CVS Health is seeking a Certified Coding Analyst to perform comprehensive medical record audits and ensure coding accuracy and compliance. You will research CPT/HCPCS guidelines, review documentation, and identify potential billing errors, explaining decisions clearly to internal partners.

The role requires CPC certification, 2+ years of coding/auditing experience, and strong knowledge of CPT/HCPCS/ICD-10. Proficiency with Excel and Word is expected, with the ability to communicate findings