Senior Medical Coding Auditor & Compliance Analyst

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

Job summary

CVS Health Corporation in Madison, WI 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 CMS 1500/UB04 guidelines. The role emphasizes thorough documentation and clear findings.

You will audit records, discuss cases with Medical Directors, identify coding issues, and support provider education. Proficiency in Excel and Word and strong written and verbal communication are required for

Qualifications

• 2+ years of medical coding, claims review, auditing experience.
• Knowledge of CPT, HCPCS, ICD-10 and modifiers.

Responsibilities

• Conduct comprehensive medical claim reviews for waste and error.
• Prepare clear summaries of findings and present outcomes to internal partners.
• Track coding and billing issues to inform process improvements.

Skills

Medical coding

Attention to detail

Written communication

Verbal communication

CPT/HCPCS/ICD-10 knowledge

Education

CPC certification

High School diploma

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health Corporation in Madison, WI 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 CMS 1500/UB04 guidelines. The role emphasizes thorough documentation and clear findings.

You will audit records, discuss cases with Medical Directors, identify coding issues, and support provider education. Proficiency in Excel and Word and strong written and verbal communication are required for