Medical Coding Auditor: Compliance & Audit Expert

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

Benefits offered by this job

Medical, Dental & Vision

Paid Time Off

Retirement Savings

Wellness programs

Bonus eligibility

Job summary

CVS Health Corporation in Olympia, WA is seeking a Certified Coding Analyst to perform medical claim reviews for waste and error, ensuring coding accuracy and compliant documentation. You will audit CPT/HCPCS/ICD-10 coding, apply CMS and state guidelines, and collaborate with Medical Directors to validate decisions.

Responsibilities include researching coding questions, identifying billing issues, preparing concise findings, and communicating outcomes to partners.

Qualifications

• CPC certification required and up-to-date with coding guidelines (CPT/HCPCS/ICD-10).
• 2+ years of experience in medical coding, claims review, auditing.

Responsibilities

• Conduct comprehensive medical record audits to ensure billed codes align with documentation.
• Research CMS/state guidelines related to audits with minimal support.
• Review cases with Medical Directors to validate decisions.

Skills

CPC Certification

Medical coding

Claims review

Auditing

Attention to detail

Data interpretation

Written communication

Verbal communication

Education

AAPC CPC Certification

High School Diploma or GED

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health Corporation in Olympia, WA is seeking a Certified Coding Analyst to perform medical claim reviews for waste and error, ensuring coding accuracy and compliant documentation. You will audit CPT/HCPCS/ICD-10 coding, apply CMS and state guidelines, and collaborate with Medical Directors to validate decisions.

Responsibilities include researching coding questions, identifying billing issues, preparing concise findings, and communicating outcomes to partners.