CPC: Medical Coding & Compliance Auditor

Hispanic Alliance for Career Enhancement; California (MO); Hybrid; USD 56,144 - 93,574; Full time

Benefits offered by this job

Benefits package

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to review medical records for the Special Investigations Unit (SIU) to ensure coding compliance across medical, behavioral, and other healthcare providers.

Responsibilities include comprehensive audits, detailed findings, and clear communication with investigators, regulators and providers. Requires CPC, 3+ years of coding/audit experience, and strong Excel/Word skills.

Qualifications

• AAPC CPC certification required.
• 3+ years of medical coding or audit experience.
• Knowledge of CPT, HCPCS, ICD-10, CMS 1500 and UB04 data elements.

Responsibilities

• Audit medical records for CPT/HCPCS alignment.
• Provide written summaries of findings.
• Articulate findings to investigators and regulators.
• Identify billing errors, abuse, and fraud.
• Maintain records and meet performance metrics.

Skills

CPC Certification

Medical coding

CMS 1500 / UB04

Excel

Word

Education

GED or equivalent

AAPC CPC Certification

Tools

Excel

Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to review medical records for the Special Investigations Unit (SIU) to ensure coding compliance across medical, behavioral, and other healthcare providers.

Responsibilities include comprehensive audits, detailed findings, and clear communication with investigators, regulators and providers. Requires CPC, 3+ years of coding/audit experience, and strong Excel/Word skills.