SIU Medical & Behavioral Health Coder & Investigator

CVS Health Corporation; Jefferson City (MO); On-site; USD 44,000 - 94,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus program

Paid time off

Job summary

CVS Health Corporation seeks a Certified Professional Coder to perform medical record reviews for the SIU to ensure coding accuracy and compliant documentation. The role requires CPT/HCPCS knowledge and the ability to discuss findings with investigators, regulators, and providers.

Qualified candidates will have 3+ years of coding experience, including review/audit work, CPC certification, and proficiency in Excel/Word. Travel may be needed for this role. Full-time with comprehensive benefits.

Qualifications

• Minimum of 3 years of medical/behavioral health coding experience, with 1–2 years in current professional coding.
• Knowledge of CPT, HCPCS, Revenue Codes, CMS 1500 and UB04 data elements.
• Ability to interpret and apply coding policies consistently.

Responsibilities

• Conduct comprehensive medical record reviews to verify codes and documentation.
• Provide detailed written summaries of review findings.
• Articulate findings to investigators, leadership, regulators and providers.
• Research CMS/state guidelines relevant to the review process.
• Review cases with Medical Directors to validate decisions.
• Identify potential billing errors, abuse, or fraud and propose savings opportunities.
• Maintain records and documentation in accordance with workflows.

Skills

Medical coding

Auditing

Attention to detail

Communication

Education

AAPC CPC Certification

GED or High School diploma

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health Corporation seeks a Certified Professional Coder to perform medical record reviews for the SIU to ensure coding accuracy and compliant documentation. The role requires CPT/HCPCS knowledge and the ability to discuss findings with investigators, regulators, and providers.

Qualified candidates will have 3+ years of coding experience, including review/audit work, CPC certification, and proficiency in Excel/Word. Travel may be needed for this role. Full-time with comprehensive benefits.