Medical Coding Auditor — Compliance & Audit Expert

Internationalinsuranceprofessionals; Jackson (MS); On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Certified Coding Analyst to perform medical claim reviews for waste and error, ensuring coding accuracy and compliance with CPT/HCPCS, ICD-10, and modifiers. You will audit medical records, discuss cases with Medical Directors, and identify billing issues.

This full-time role requires a CPC certification and 2+ years of coding experience, with MS Excel/Word proficiency and strong attention to detail.

Qualifications

• AAPC CPC certification and 2+ years of medical coding or claims review experience.
• Strong knowledge of CPT, HCPCS, ICD-10, modifiers, CMS 1500 and UB04.
• Proficient with Excel and Word; detail-oriented and analytical.

Responsibilities

• Audit medical records to ensure CPT/HCPCS and modifiers match documentation.
• Research CMS guidelines and policies; discuss cases with Medical Directors as needed.
• Identify billing errors, waste, and potential fraud; prepare findings summaries.
• Present outcomes clearly to internal partners and support provider education.

Skills

CPC certification

2+ years experience

Coding guidelines knowledge

Attention to detail

Communication skills

MS Office (Excel, Word)

Education

AAPC CPC Certification

High School diploma

Tools

Excel

Word

Encoder Pro

Job description

CVS Health is seeking a Certified Coding Analyst to perform medical claim reviews for waste and error, ensuring coding accuracy and compliance with CPT/HCPCS, ICD-10, and modifiers. You will audit medical records, discuss cases with Medical Directors, and identify billing issues.

This full-time role requires a CPC certification and 2+ years of coding experience, with MS Excel/Word proficiency and strong attention to detail.