CPC Coding Auditor - Medical & Behavioral Health

Istss; Oklahoma City (OK); Hybride; USD 44 000 - 94 000; Plein temps

Avantages offerts par ce poste

Comprehensive benefits

Bonus program

Paid time off

Résumé du poste

CVS Health is seeking a Certified Professional Coder (CPC) for the Special Investigations Unit to review medical records, ensure CPT/HCPCS accuracy, and identify potential billing issues.

Requires 3+ years of medical/behavioral health coding, CPC certification, knowledge of CPT/HCPCS/Revenue Codes, CMS 1500/UB04 data elements, and willingness to travel. Offers competitive benefits and bonus potential.

Qualifications

• Must hold AAPC CPC certification and have 3+ years in medical coding with record reviews.
• Experience with CPT, HCPCS, Revenue Codes and CMS 1500/UB04 data elements.
• Ability to interpret and apply coding policies consistently.
• Strong written/verbal communication and documentation auditing skills.
• Availability to travel as needed.

Responsabilités

• Conduct comprehensive medical record reviews for CPT/HCPCS/modifiers.
• Provide detailed written summaries of findings for investigators and leadership.
• Articulate findings to stakeholders including state regulators and legal teams.
• Research CMS guidelines and apply them to coding review processes.
• Collaborate with Medical Directors to validate decisions and discuss cases.
• Identify potential billing errors, abuse, and fraud; suggest improvement opportunities.

Connaissances

CPC certification

Medical coding

Coding documentation

Travel readiness

Microsoft Excel

CMS guidelines

Formation

AAPC CPC Certification

GED or High School diploma

Outils

Excel

Word

Description du poste

CVS Health is seeking a Certified Professional Coder (CPC) for the Special Investigations Unit to review medical records, ensure CPT/HCPCS accuracy, and identify potential billing issues.

Requires 3+ years of medical/behavioral health coding, CPC certification, knowledge of CPT/HCPCS/Revenue Codes, CMS 1500/UB04 data elements, and willingness to travel. Offers competitive benefits and bonus potential.