Senior Coding Quality Analyst (CPC) – SIU Investigator

CVS Health; Saint Paul (MN); On-site; USD 47,000 - 102,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Competitive benefits

Job summary

CVS Health is seeking a Senior Coding Quality Analyst (CPC) for the Special Investigations Unit to review medical claims for coding accuracy and compliance with CPT/HCPCS/ICD-10 guidelines and payer requirements.

You will analyze complex medical records, identify billing issues, document findings, and mentor coders while supporting process improvements. This full-time role offers comprehensive benefits and growth opportunities.

Qualifications

• AAPC CPC certification required and maintained.
• Experience reviewing coding decisions for quality.
• Familiar with CPT/HCPCS/ICD-10 guidelines and payer rules.

Responsibilities

• Conduct comprehensive quality reviews of completed medical coding reviews.
• Analyze data, documentation, and evidence to identify billing errors or fraud.
• Prepare detailed written summaries of findings for leadership.
• Mentor coders on quality and documentation standards.

Skills

Excellent communication skills

Analytical skills

Attention to detail

Reviewing coding decisions

Education

AAPC CPC certification

GED or High School diploma

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health is seeking a Senior Coding Quality Analyst (CPC) for the Special Investigations Unit to review medical claims for coding accuracy and compliance with CPT/HCPCS/ICD-10 guidelines and payer requirements.

You will analyze complex medical records, identify billing issues, document findings, and mentor coders while supporting process improvements. This full-time role offers comprehensive benefits and growth opportunities.