CPC SIU Investigator: Medical & Behavioral Health Coding

Pennsylvania Psychological Association; Austin (TX); Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Retirement Plan

Wellness programs

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding accuracy and compliant documentation across medical, behavioral health, transportation and other providers.

You will articulate findings to investigators and leadership, stay current with coding guidelines, and help identify billing errors, fraud risks and opportunities for savings.

Qualifications

• 3+ years of medical/behavioral health coding experience with current review experience.
• Knowledge of CPT, HCPCS, Revenue Codes and CMS data elements.
• Ability to interpret and apply coding policies consistently.

Responsibilities

• Perform comprehensive medical record reviews to verify CPT/HCPCS/Revenue codes align with documentation.
• Provide detailed written summaries of findings for investigators and leadership.
• Identify billing errors, abuse, and fraud indicators during reviews.

Skills

CPC coding

Medical record review

Documentation auditing

CMS guidelines

Data interpretation

Education

AAPC CPC certification

GED or High School diploma

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding accuracy and compliant documentation across medical, behavioral health, transportation and other providers.

You will articulate findings to investigators and leadership, stay current with coding guidelines, and help identify billing errors, fraud risks and opportunities for savings.