Hybrid Waste & Error Coding Manager-Lead & Elevate Quality

CVS Health Corporation; Raleigh (NC); Hybrid; USD 54,000 - 146,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Hybrid work environment

Job summary

CVS Health is seeking a Waste & Error Certified Coding Manager to lead the Certified Coding Analysts and Team Leads, overseeing medical claim reviews, audits, and fraud, waste and abuse detection. You will drive staffing, performance management, and accountability while partnering with senior leaders to ensure compliance and high-quality outcomes.

The role emphasizes operational leadership, policy interpretation, and continuous improvement in coding audit operations within a hybrid work

Qualifications

• Active AAPC Certified Coder CPC, CCS, RHIT or RN license with significant coding/auditing experience.
• 5+ years of experience in medical coding, claims review, auditing, payment integrity, fraud, waste, abuse, or error review.
• 2+ years of people leadership, supervisory, or team management experience.
• Experience leading coding quality programs, productivity management, workload oversight, and remediation activities.
• Strong knowledge of CPT, HCPCS, ICD-10, CMS 1500, UB-04, coding compliance, and reimbursement requirements.

Responsibilities

• Lead, coach, and develop a team of Certified Coding Analysts and Senior Analysts.
• Oversee staffing, performance management, and workload oversight for coding operations.
• Ensure adherence to coding guidelines and auditing standards across reviews and appeals.
• Develop KPIs and monitor productivity, quality, and operational outcomes.
• Collaborate with senior leadership and cross-functional partners on governance and strategic initiatives.

Skills

Certified Coder

Medical coding

People leadership

CPT/HCPCS/ICD-10

Compliance knowledge

Excel/Word

Communication

Policy research

EncoderPro

Education

High school diploma or GED

Tools

EncoderPro

Job description

CVS Health is seeking a Waste & Error Certified Coding Manager to lead the Certified Coding Analysts and Team Leads, overseeing medical claim reviews, audits, and fraud, waste and abuse detection. You will drive staffing, performance management, and accountability while partnering with senior leaders to ensure compliance and high-quality outcomes.

The role emphasizes operational leadership, policy interpretation, and continuous improvement in coding audit operations within a hybrid work