SIU Medical & Behavioral Health Coding Expert

Istss; Columbia (SC); 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, ensuring coding accuracy and compliance with CPT/HCPCS and Revenue Codes. The CPC will review documentation, articulate findings to investigators, and help identify billing errors, fraud, and savings opportunities.

The role is full-time with typical 40 hours per week, offering comprehensive benefits and potential bonuses; travel may be required to support audits and

Qualifications

• Certified Professional Coder (CPC) certification required.
• 3+ years of medical/behavioral health coding experience, including medical record review and auditing.
• Experience with CPT, HCPCS, Revenue Codes, CMS 1500 and UB04 elements.
• Proficiency in Microsoft Excel and Word.

Responsibilities

• Conduct comprehensive medical record reviews to verify CPT/HCPCS/revenue code accuracy against documentation.
• Provide detailed written summaries of review findings.

Skills

CPC certification

Medical coding

CPT/HCPCS knowledge

CMS 1500 & UB04

Excel & Word proficiency

Travel ability

Education

AAPC CPC Certification

GED or High School diploma

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit, ensuring coding accuracy and compliance with CPT/HCPCS and Revenue Codes. The CPC will review documentation, articulate findings to investigators, and help identify billing errors, fraud, and savings opportunities.

The role is full-time with typical 40 hours per week, offering comprehensive benefits and potential bonuses; travel may be required to support audits and