CPC Medical & Behavioral Coding Auditor

CVS Health; Connecticut; On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Bonus program eligibility

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) for the Special Investigations Unit to perform medical claim reviews ensuring coding accuracy and compliant documentation. You will review CPT/HCPCS codes, generate written findings, communicate with investigators and regulators, and identify potential billing errors or fraud while staying current with coding guidelines.

This full-time role requires CPC certification, 3+ years coding experience and proficiency in Excel and Word, with

Qualifications

• AAPC CPC certification and 3+ years coding experience.
• Experience with CPT, HCPCS, Revenue Codes and CMS 1500/UB04.
• Proficient in Microsoft Excel and Word; ability to travel.

Responsibilities

• Conduct comprehensive medical record reviews to ensure codes billed are consistent with documentation.
• Provide written summaries of findings and articulate results to investigators, leaders, regulators, and counsel.
• Identify potential billing errors, abuse and fraud; assist investigations and research.

Skills

CPC certification

Medical coding experience

Education

GED or High School diploma

AAPC CPC Certification

Tools

Excel

Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) for the Special Investigations Unit to perform medical claim reviews ensuring coding accuracy and compliant documentation. You will review CPT/HCPCS codes, generate written findings, communicate with investigators and regulators, and identify potential billing errors or fraud while staying current with coding guidelines.

This full-time role requires CPC certification, 3+ years coding experience and proficiency in Excel and Word, with