SIU Medical & Behavioral Health Coding Specialist

Preferra Insurance; Columbus (OH); On-site; USD 44,000 - 94,000; Full time

Job summary

CVS Health is hiring a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU. The role requires detailed record reviews, accurate coding, and clear written summaries for internal and external stakeholders.

Travel may be required; strong knowledge of CPT, HCPCS, CMS guidelines is essential. Candidates should have CPC certification, 3+ years of coding/record review experience, and proficiency with Excel/Word.

Qualifications

• Must hold AAPC CPC certification and have 3+ years of medical or behavioral health coding experience, including record review and auditing.
• Proficient in CPT, HCPCS, Revenue Codes, CMS 1500/UB04 data elements.
• Able to interpret and apply coding policies consistently and communicate findings.

Responsibilities

• Conduct comprehensive medical record reviews to verify appropriate CPT/HCPCS/revenue code usage.
• Provide written summaries of review findings for investigators and leadership.
• Communicate findings to diverse stakeholders including investigators, management, and regulators.

Education

AAPC CPC certification

GED or High School diploma

Tools

Excel

Word

Job description

CVS Health is hiring a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU. The role requires detailed record reviews, accurate coding, and clear written summaries for internal and external stakeholders.

Travel may be required; strong knowledge of CPT, HCPCS, CMS guidelines is essential. Candidates should have CPC certification, 3+ years of coding/record review experience, and proficiency with Excel/Word.