CPC Investigator: Medical Coding & Compliance

DaMar Staffing; Frankfort (KY); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform comprehensive medical claim reviews and ensure coding accuracy across medical, behavioral health and related services. The role requires 3+ years of coding or auditing, CPC certification, and strong knowledge of CPT/HCPCS rules.

Travel for meetings may be required. The position offers a full‑time schedule with a robust benefits package including medical, dental and vision coverage, paid time off, retirement plans and wellness

Qualifications

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

Responsibilities

• Conduct comprehensive medical record reviews for billing consistency.
• Provide detailed written summaries of review findings.
• Articulate findings to investigators, leadership, and regulators.
• Review cases with Medical Directors to validate decisions.
• Assist with investigative research related to coding questions.
• Identify potential billing errors, abuse and fraud.
• Identify opportunities for savings warranting prepayment review.
• Maintain records and documentation; travel as needed.

Skills

Medical coding

CPT coding

Regulatory research

Analytical thinking

Documentation auditing

Education

GED or equivalent

AAPC CPC Certification

Tools

Microsoft Excel

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform comprehensive medical claim reviews and ensure coding accuracy across medical, behavioral health and related services. The role requires 3+ years of coding or auditing, CPC certification, and strong knowledge of CPT/HCPCS rules.

Travel for meetings may be required. The position offers a full‑time schedule with a robust benefits package including medical, dental and vision coverage, paid time off, retirement plans and wellness