SIU Medical & Behavioral Health Coding Analyst - CPC

Pennsylvania Psychological Association; Richmond (VA); Hybrid; USD 44,000 - 94,000; Full time

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit. The CPC will determine correct coding and ensure documentation matches CPT/HCPCS/Revenue codes while meeting state, federal and company requirements.

Responsibilities include writing detailed findings, articulating results to investigators, identifying billing errors and fraud risks, and maintaining case records.

Qualifications

• CPC certification and coding knowledge required.
• Experience interpreting CPT/HCPCS/Revenue Codes and CMS guidelines.
• Strong written communication and documentation auditing skills.

Responsibilities

• Conduct comprehensive medical record reviews ensuring CPT/HCPCS/Revenue codes match documentation.
• Provide detailed written summaries of findings.
• Articulate findings to investigators, plan leadership, regulators and others.

Skills

CPC coding

Attention to detail

Written communication

Education

AAPC CPC Certification

GED or High School diploma

Tools

MS Excel

MS Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit. The CPC will determine correct coding and ensure documentation matches CPT/HCPCS/Revenue codes while meeting state, federal and company requirements.

Responsibilities include writing detailed findings, articulating results to investigators, identifying billing errors and fraud risks, and maintaining case records.