Medical Coding Auditor & Compliance Analyst

CVS Health Corporation; Lincoln (NE); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Employee discounts

Job summary

CVS Health Corporation is seeking a Certified Coding Analyst in Lincoln, NE. You will review medical records to ensure accurate CPT/HCPCS coding and compliance with state and federal guidelines.

The role requires CPC certification and 2+ years in coding, with strong attention to detail and clear communication. This full-time position offers a comprehensive benefits package and a base pay range of $43,888 to $102,081, with eligibility for CVS Health bonus programs.

Qualifications

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

Responsibilities

• Conduct comprehensive medical record audits to ensure CPT/HCPCS or modifiers billed align with documentation.
• Research and apply CMS and organizational guidelines related to audits.
• Review cases with Medical Directors to validate decisions.
• Assist with coding policy investigations and education.
• Identify billing errors, abuse, and fraud.
• Prepare clear summaries of findings and present outcomes to partners.
• Track recurring coding issues to inform process improvements.

Skills

Attention to detail

Communication skills

Analytical thinking

Education

AAPC CPC certification

High School diploma or GED

Tools

Excel

Word

Job description

CVS Health Corporation is seeking a Certified Coding Analyst in Lincoln, NE. You will review medical records to ensure accurate CPT/HCPCS coding and compliance with state and federal guidelines.

The role requires CPC certification and 2+ years in coding, with strong attention to detail and clear communication. This full-time position offers a comprehensive benefits package and a base pay range of $43,888 to $102,081, with eligibility for CVS Health bonus programs.