CPC SIU Medical & Behavioral Health Coder & Reviewer

Pennsylvania Psychological Association; Lincoln (NE); Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is hiring a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding accuracy and compliance with state and federal guidelines. You will review records across medical, behavioral health, and related services and articulate findings to investigators and leadership.

This full-time role requires CPC certification, 3+ years of coding experience, proficiency with CPT/HCPCS and CMS data elements, and travel as needed.

Qualifications

• Minimum 3 years of professional medical or behavioral health coding experience.
• Experience with medical record review and documentation auditing.
• Ability to interpret and apply coding policies and guidelines.
• Proficiency with CPT, HCPCS, Revenue Codes; CMS 1500/UB04 data elements.

Responsibilities

• Conduct comprehensive medical record reviews ensuring CPT/HCPCS/Revenue codes align with documentation.
• Provide detailed written summaries of review findings for investigators and leadership.
• Identify potential billing errors, abuse, and fraud.
• Maintain organized records and follow established workflows to meet metrics.

Skills

CPC certification

Healthcare coding

Verbal and written communication

Travel willingness

Education

CPC certification (AAPC)

GED or high school diploma

Tools

Excel

Word

Job description

CVS Health is hiring a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding accuracy and compliance with state and federal guidelines. You will review records across medical, behavioral health, and related services and articulate findings to investigators and leadership.

This full-time role requires CPC certification, 3+ years of coding experience, proficiency with CPT/HCPCS and CMS data elements, and travel as needed.