Senior Behavioral Health Coding Auditor & Mentor

Voices for Voices; Hartford (CT); On-site; USD 47,000 - 112,000; Full time

Job summary

CVS Health is seeking a qualified Behavioral Health Medical Coder to conduct comprehensive medical record audits ensuring CPT/HCPCS and ICD-10 alignment with documentation. You will produce detailed written findings and articulate them to investigators, plan leadership, and regulators as needed.

Responsibilities include reviewing cases with Medical Directors, mentoring junior coders, and collaborating with data analytics to identify prepayment savings and ensure compliant coding practices.

Qualifications

• AAPC CPC certification required.
• 3+ years Behavioral Health medical coding or auditing experience.
• Strong knowledge CPT/HCPCS/ICD-10 guidelines.
• CMS 1500 and UB04 data elements experience.
• Proficient in Microsoft Excel and Word.
• Experience auditing others and mentoring.

Responsibilities

• Conduct comprehensive medical record audits for CPT/HCPCS or modifiers vs. documentation.
• Handle complex coding reviews and resolve issues for audits and rework.
• Provide detailed written summaries of findings.
• Articulate findings to investigators, plan leadership, and regulators as needed.
• Review cases with Medical Directors to validate decisions.
• Mentor new coders and provide guidance on coding and reviews.

Skills

CPC Certification

Behavioral Health coding

CPT/HCPCS/ICD-10 knowledge

CMS 1500/UB04

Policy research

Education

AAPC CPC Certification

GED or High School diploma

Tools

Excel

Word

Job description

CVS Health is seeking a qualified Behavioral Health Medical Coder to conduct comprehensive medical record audits ensuring CPT/HCPCS and ICD-10 alignment with documentation. You will produce detailed written findings and articulate them to investigators, plan leadership, and regulators as needed.

Responsibilities include reviewing cases with Medical Directors, mentoring junior coders, and collaborating with data analytics to identify prepayment savings and ensure compliant coding practices.