Medical Coding Auditor & Compliance Specialist (CPC)

Hispanic Alliance for Career Enhancement; Kansas; Hybrid; USD 43,888 - 93,574; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding compliance across medical, behavioral, transportation and other healthcare providers. The CPC will review records, determine correct coding, and ensure state, federal and company requirements are met.

The role requires CPC certification, 3+ years in coding or auditing, and strong Excel/Word skills.

Qualifications

• 3+ years of experience in medical coding or documentation auditing.
• Knowledge of CPT, HCPCS, ICD-10, CMS 1500 and UB04 elements.
• Experience researching coding and policies; proficient with Excel/Word.

Responsibilities

• Conduct comprehensive medical record audits to verify CPT/HCPCS and modifiers against documentation.
• Provide detailed written summaries of audit findings for investigations and leadership.
• Articulate findings to investigators, regulators and counsel; identify billing errors, fraud, and opportunities for savings.

Skills

Attention to detail

Microsoft Excel

Microsoft Word

Education

AAPC CPC Certification

GED or equivalent

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding compliance across medical, behavioral, transportation and other healthcare providers. The CPC will review records, determine correct coding, and ensure state, federal and company requirements are met.

The role requires CPC certification, 3+ years in coding or auditing, and strong Excel/Word skills.