CPC Medical Coding Auditor & Compliance Specialist

DaMar Staffing; Mountain Home (ID); On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in Idaho is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, verifying coding accuracy and documentation across medical, behavioral health and other healthcare services. This full-time role requires CPC certification and 3+ years of coding or auditing experience.

You will interpret state and CMS guidelines, prepare detailed findings, discuss cases with Medical Directors, and help identify errors, savings opportunities and potential fraud.

Qualifications

• AAPC CPC certification required and 3+ years in medical coding or auditing.
• Familiarity with CPT/HCPCS/ICD-10/CMS 1500/UB04 elements and guidelines.
• Experience with MS Excel and Word.

Responsibilities

• Audit medical records for CPT/HCPCS accuracy and documentation alignment.
• Provide detailed written summaries of review findings.
• Articulate findings to investigators, leaders, and regulators.
• Apply state or CMS guidelines with minimal support.
• Discuss cases with Medical Directors to validate decisions.
• Identify billing errors, potential fraud, and savings opportunities.
• Maintain records and follow established workflows to meet metrics.
• Keep up-to-date coding knowledge with changes to compliance.

Skills

Attention to detail

Communication skills

Behavioral health coding

Regulatory knowledge

Education

GED or equivalent

AAPC CPC Certification

CPMA

Tools

Excel

Word

Job description

CVS Health in Idaho is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, verifying coding accuracy and documentation across medical, behavioral health and other healthcare services. This full-time role requires CPC certification and 3+ years of coding or auditing experience.

You will interpret state and CMS guidelines, prepare detailed findings, discuss cases with Medical Directors, and help identify errors, savings opportunities and potential fraud.