SIU Medical & Behavioral Health Coding Auditor

Voices for Voices; Augusta (ME); Ibrido; USD 44.000 - 94.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Bonus eligibility

Descrizione del lavoro

CVS Health seeks a Certified Professional Coder (CPC) in Augusta, ME to perform medical record reviews for the Special Investigations Unit, ensuring CPT/HCPCS validity and compliant documentation. The role requires 3+ years of professional coding experience and strong CPT/HCPCS knowledge.

You will identify billing errors, discuss findings with Medical Directors and leadership, and ensure CMS guidelines are applied consistently.

Competenze

• AAPC CPC certification and at least 3 years of coding experience with medical record review.
• Strong knowledge of CPT, HCPCS and Revenue Codes and documentation auditing.
• Experience with CMS 1500/UB04 data elements and applying coding guidelines.

Mansioni

• Conduct comprehensive medical record reviews to verify codes and documentation.
• Provide written summaries of findings and articulate them to investigators and leadership.
• Identify billing errors, potential fraud, and opportunities for savings.
• Maintain records and follow workflows to meet metrics.
• Stay up-to-date with coding compliance and reimbursement changes.

Conoscenze

CPC certification

Medical coding

CPT/HCPCS knowledge

CMS 1500 / UB04

Documentation auditing

Microsoft Excel

Travel required

Formazione

AAPC CPC Certification

GED or High School diploma

Strumenti

Microsoft Word

Descrizione del lavoro

CVS Health seeks a Certified Professional Coder (CPC) in Augusta, ME to perform medical record reviews for the Special Investigations Unit, ensuring CPT/HCPCS validity and compliant documentation. The role requires 3+ years of professional coding experience and strong CPT/HCPCS knowledge.

You will identify billing errors, discuss findings with Medical Directors and leadership, and ensure CMS guidelines are applied consistently.