Lead CPC Auditor & SIU Manager

CVS Health Corporation; New York (NY); On-site; USD 54,000 - 159,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health Corporation seeks a CPC Manager to oversee a team of medical coders within the Special Investigations Unit (SIU), ensuring CPT/HCPCS/ICD-10 compliance and accurate documentation during the review of medical records.

Lead audits, mentor staff, set goals, and communicate findings to investigators, Medicaid plan leadership, and regulators; collaborate with Medical Directors and oversee workload to match development needs.

Qualifications

• AAPC Coding certification required.
• 5+ years of medical coding or documentation auditing experience.
• Strong knowledge of CPT, HCPCS, ICD-10, CMS 1500, UB04 data elements.
• Up-to-date coding knowledge and ability to research policies.
• Proficiency in Microsoft Excel and Word.
• Excellent analytical and leadership abilities.

Responsibilities

• Lead and mentor a team of CPCs, providing training and guidance in coding practices.
• Conduct regular audits of coding and documentation to ensure compliance with CPT/HCPCS and other standards.
• Manage workload and allocate responsibilities to match team development needs.
• Collaborate with Medical Directors to validate decisions and discuss complex cases.
• Communicate findings clearly to investigators, Medicaid plan leadership, law enforcement, and regulators.
• Develop training and onboarding programs for new team members.

Skills

Leadership & mentoring

Analytical thinking

Attention to detail

Data interpretation

Communication skills

Education

AAPC Coding certification

Tools

Excel

Word

Job description

CVS Health Corporation seeks a CPC Manager to oversee a team of medical coders within the Special Investigations Unit (SIU), ensuring CPT/HCPCS/ICD-10 compliance and accurate documentation during the review of medical records.

Lead audits, mentor staff, set goals, and communicate findings to investigators, Medicaid plan leadership, and regulators; collaborate with Medical Directors and oversee workload to match development needs.