CPC: Medical Coding & Investigations Specialist

DaMar Staffing; Bismarck (ND); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Retirement savings options

Paid time off

Wellness programs

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews ensuring coding accuracy across medical, behavioral health and related services in North Dakota. The role requires CPC certification and 3+ years in medical coding or documentation auditing, with strong CPT/HCPCS knowledge and Excel proficiency.

You'll review records, summarize findings, communicate with investigators and regulators, and help identify opportunities for savings while traveling for meetings

Qualifications

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

Responsibilities

• Conduct comprehensive medical record reviews to ensure billing aligns with records.
• Provide detailed written summaries of review findings.
• Articulate findings to investigators, plan leadership, and regulators.
• Identify potential billing errors, abuse, and fraud in reviews.
• Travel for meetings and potential testimony.

Skills

Certified Professional Coder (CPC)

Medical coding

Excel

Education

GED or equivalent

AAPC Certified Professional Coder Certification (CPC)

Tools

Microsoft Excel

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews ensuring coding accuracy across medical, behavioral health and related services in North Dakota. The role requires CPC certification and 3+ years in medical coding or documentation auditing, with strong CPT/HCPCS knowledge and Excel proficiency.

You'll review records, summarize findings, communicate with investigators and regulators, and help identify opportunities for savings while traveling for meetings