CPC SIU Health Coding Auditor

CVS Health Corporation; Pierre (SD); On-site; USD 44,000 - 94,000; Full time

Job summary

CVS Health Corporation is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU), ensuring coding accuracy and compliant documentation across CPT/HCPCS/Revenue Codes.

This full-time role requires CPC certification, 3+ years of medical coding with record review, ability to articulate findings, and willingness to travel. Competitive pay and comprehensive benefits.

Qualifications

• CPC certification required and 3+ years of medical or behavioral health coding experience.
• Experience with medical record reviews and documentation auditing.
• Familiarity with CPT, HCPCS, and Revenue Codes; CMS 1500 and UB04 data elements.

Responsibilities

• Conduct comprehensive medical record reviews to verify CPT/HCPCS/Revenue Code accuracy.
• Provide detailed written summaries of review findings for investigators and leadership.
• Identify billing errors, abuse, and fraud; document findings and support investigations.

Skills

CPC coding experience

Medical record review

Written communication

Education

CPC certification

GED or High School diploma

Tools

Excel

Word

CMS guidelines

Job description

CVS Health Corporation is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU), ensuring coding accuracy and compliant documentation across CPT/HCPCS/Revenue Codes.

This full-time role requires CPC certification, 3+ years of medical coding with record review, ability to articulate findings, and willingness to travel. Competitive pay and comprehensive benefits.