SIU Medical & Behavioral Health Coding Auditor

Voices for Voices; Topeka (KS); Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

retirement savings options

Wellness programs

Job summary

CVS Health seeks a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit, ensuring coding accuracy across medical, behavioral health, and related services. The CPC must determine correct coding and documentation during chart reviews and ensure regulatory compliance.

This full-time role requires AAPC CPC certification, 3+ years of coding experience (including review/audit), CPT/HCPCS knowledge, and proficiency with Excel/Word.

Qualifications

• AAPC CPC certification required.
• Minimum 3 years of medical/behavioral health coding experience with 1–2 years of current professional coding.
• Knowledge of CPT, HCPCS, and Revenue Codes.
• CMS 1500 and UB04 data elements knowledge.
• Ability to interpret and apply coding policies and guidelines.
• Experience with Excel and Word.
• Ability to travel if needed.

Responsibilities

• Perform medical claim reviews for the SIU to ensure coding compliance.
• Determine correct coding and documentation during medical record reviews.
• Ensure state, federal and company requirements are met and flag concerning billing patterns.
• Maintain up-to-date coding knowledge on changes to compliance and reimbursement.

Skills

Experience in medical coding

CPC knowledge

CPT/HCPCS knowledge

CMS 1500/UB04 data elements

Documentation auditing

Travel ability

Microsoft Excel

Microsoft Word

Education

AAPC CPC certification

GED or High School diploma

Job description

CVS Health seeks a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit, ensuring coding accuracy across medical, behavioral health, and related services. The CPC must determine correct coding and documentation during chart reviews and ensure regulatory compliance.

This full-time role requires AAPC CPC certification, 3+ years of coding experience (including review/audit), CPT/HCPCS knowledge, and proficiency with Excel/Word.