CPC-Certified SIU Coding Auditor

Voices for Voices; Tallahassee (FL); On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision care

Paid time off

Retirement options

Job summary

CVS Health is hiring a Certified Professional Coder (CPC) for its Special Investigations Unit (SIU) to review medical records for coding accuracy and compliance. The role involves analyzing CPT/HCPCS codes, documenting findings, and communicating with investigators and regulators.

The position requires 3+ years in professional coding, including medical record review, and proficiency with CPT/HCPCS and CMS guidelines. Travel may be required, and a strong eye for detail is essential.

Qualifications

• 3+ years of medical or behavioral health coding experience, including record review and documentation auditing.
• Ability to interpret and apply CPT/HCPCS/Revenue Code policies consistently.
• Familiarity with CMS 1500 and UB04 data elements.
• Proficient with MS Office (Excel/Word) and ability to travel if needed.

Responsibilities

• Conduct comprehensive medical record reviews ensuring codes and modifiers align with documentation.
• Provide detailed written findings and articulate results to investigators and leadership.
• Identify potential billing errors or fraud and suggest savings opportunities.
• Maintain accurate records and follow workflows to meet performance metrics.

Skills

Medical coding

Audit skills

Communication

Travel

Education

CPC certification

GED or High School diploma

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health is hiring a Certified Professional Coder (CPC) for its Special Investigations Unit (SIU) to review medical records for coding accuracy and compliance. The role involves analyzing CPT/HCPCS codes, documenting findings, and communicating with investigators and regulators.

The position requires 3+ years in professional coding, including medical record review, and proficiency with CPT/HCPCS and CMS guidelines. Travel may be required, and a strong eye for detail is essential.