Medical Coding Auditor & Compliance Analyst

CVS Health Corporation; Baton Rouge (LA); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Bonus/incentive program

Comprehensive benefits package

Paid time off

Job summary

CVS Health Corporation invites a Certified Coding Analyst to perform medical claim reviews for waste and error, ensuring coding accuracy per CPT/HCPCS/ICD-10 standards and compliant documentation across medical and institutional providers.

Responsibilities include audits, policy research, interacting with Medical Directors, and identifying billing issues. Requires CPC, 2+ years coding experience, and strong Excel/Word skills. Full-time, on-site in Baton Rouge, LA with comprehensive benefits.

Qualifications

• AAPC CPC certification required.
• 2+ years of experience in medical coding, claims review, auditing.
• Strong knowledge of CPT, HCPCS, ICD-10, and modifiers.
• CMS 1500 and UB04 data elements.
• Maintains up-to-date coding knowledge including changes to compliance and reimbursement.

Responsibilities

• Conduct comprehensive medical record audits to verify CPT/HCPCS/billed modifiers align with documentation.
• Research and apply state, CMS, and organizational guidelines.
• Review cases with Medical Directors to validate decisions.
• Assist with coding policy investigation related to fraud, waste and abuse.
• Identify potential billing errors and educate providers.

Skills

CPC Certification

Medical coding

Claims review

Auditing

CPT/HCPCS/ICD-10

CMS 1500/UB04

Excel

Word

Attention to detail

Communication

Education

AAPC CPC Certification

High School diploma

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health Corporation invites a Certified Coding Analyst to perform medical claim reviews for waste and error, ensuring coding accuracy per CPT/HCPCS/ICD-10 standards and compliant documentation across medical and institutional providers.

Responsibilities include audits, policy research, interacting with Medical Directors, and identifying billing issues. Requires CPC, 2+ years coding experience, and strong Excel/Word skills. Full-time, on-site in Baton Rouge, LA with comprehensive benefits.