CPC Coding Auditor & Compliance Analyst

Oak St. Health; Frankfort (KY); On-site; USD 44,000 - 102,000; Full time

Job summary

CVS Health is seeking a Certified Coding Analyst to perform audits of medical records and ensure coding accuracy in CPT/HCPCS/ICD-10 contexts. The role supports compliance with state and CMS policies and collaborates with Medical Directors to validate decisions.

The ideal candidate has 2+ years in medical coding/audit, CPC certification, and strong Excel/Word skills. This is a full-time on-site position with a comprehensive benefits package.

Qualifications

• AAPC CPC certification required.
• 2+ years of experience in medical coding, claims review or auditing.
• Strong knowledge of CPT, HCPCS, ICD-10 and modifiers.
• Familiarity with CMS 1500 and UB04 data elements.
• Proficiency with Microsoft Excel and Word.

Responsibilities

• Conduct comprehensive medical record audits to verify CPT/HCPCS/modifier billing aligns with documentation.
• Apply state, CMS and org guidelines related to audits with minimal guidance.
• Discuss cases with Medical Directors to validate decisions.
• Investigate coding questions and related policies.
• Identify billing errors, waste, abuse and fraud.
• Prepare concise summaries of findings for internal partners.
• Maintain thorough records and documentation; follow workflows to meet production metrics.

Skills

CPC Certification

Auditing experience

Excel

Verbal & written communication

Education

High School diploma or GED

AAPC CPC Certification

Tools

Excel

Word

Job description

CVS Health is seeking a Certified Coding Analyst to perform audits of medical records and ensure coding accuracy in CPT/HCPCS/ICD-10 contexts. The role supports compliance with state and CMS policies and collaborates with Medical Directors to validate decisions.

The ideal candidate has 2+ years in medical coding/audit, CPC certification, and strong Excel/Word skills. This is a full-time on-site position with a comprehensive benefits package.