CPC Investigator: Healthcare Coding & Compliance

DaMar Staffing; Des Moines (IA); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in Des Moines, IA is seeking a Certified Professional Coder (CPC) to perform medical claim reviews and ensure coding accuracy across medical, behavioral health, and related services. The role requires CPC certification, 3+ years coding experience, strong CPT/HCPCS knowledge, and proficiency with Excel; travel for meetings and testimony may be required.

The position offers a full‑time schedule with comprehensive benefits and opportunities to contribute to quality and compliance across

Qualifications

• AAPC CPC certification required.
• 3+ years of medical coding or documentation auditing experience.
• Strong knowledge of CPT, HCPCS, Revenue Codes, CMS 1500 and UB04 data elements.
• Experience researching coding, state regulations and policies.
• Working experience with Microsoft Excel.

Responsibilities

• Conduct comprehensive medical record reviews to ensure billing matches the medical record.
• Provide detailed written summaries of review findings.
• Articulate findings to investigators, plan leadership, and regulators.
• Review and discuss cases with Medical Directors to validate decisions.
• Assist with investigative research related to coding questions and policies.
• Identify potential billing errors, abuse, and fraud.
• Identify savings opportunities warranting prepayment review.
• Maintain records and documentation.
• Ability to travel for meetings and testimony.

Skills

CPC Certification

Medical coding experience

CPT/HCPCS knowledge

CMS 1500/UB04

Excel proficiency

Education

GED or equivalent

AAPC CPC Certification

Tools

MS Excel

Job description

CVS Health in Des Moines, IA is seeking a Certified Professional Coder (CPC) to perform medical claim reviews and ensure coding accuracy across medical, behavioral health, and related services. The role requires CPC certification, 3+ years coding experience, strong CPT/HCPCS knowledge, and proficiency with Excel; travel for meetings and testimony may be required.

The position offers a full‑time schedule with comprehensive benefits and opportunities to contribute to quality and compliance across