CPC-Certified SIU Health Coding Auditor

CVS Health Corporation; Baton Rouge (LA); On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Travel when needed

Job summary

CVS Health Corporation in Baton Rouge, LA is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU) and ensure coding practices align with medical record documentation. Required: at least 3 years of medical/behavioral health coding, CPC certification, CPT/HCPCS knowledge, CMS 1500/UB04 experience, and strong written/verbal communication.

This full-time role offers a comprehensive benefits package, travel as needed, and potential

Qualifications

• Minimum 3 years of medical or behavioral health coding experience, including medical record reviews.
• Ability to interpret and apply CPT/HCPCS and Revenue Codes.
• Knowledge of CMS 1500 and UB04 data elements.

Responsibilities

• Conduct comprehensive medical record reviews to ensure codes align with documentation.
• Provide detailed written summaries of findings.
• Communicate findings to investigators, leadership, and regulators.
• Identify billing errors, abuse, and fraud.
• Maintain records and follow workflows to meet metrics.

Skills

CPC certification

Medical/behavioral health coding

Medical record review

CPT/HCPCS knowledge

Education

AAPC CPC certification

GED or High School diploma

Tools

Excel

Word

Job description

CVS Health Corporation in Baton Rouge, LA is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU) and ensure coding practices align with medical record documentation. Required: at least 3 years of medical/behavioral health coding, CPC certification, CPT/HCPCS knowledge, CMS 1500/UB04 experience, and strong written/verbal communication.

This full-time role offers a comprehensive benefits package, travel as needed, and potential