SIU Medical Coder & Behavioral Health Auditor

Istss; Pierre (SD); Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement savings options

Paid time off

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding accuracy and compliant documentation across medical, behavioral health, transportation and other healthcare providers.

The role requires CPC certification, 3+ years of coding experience with record review and auditing, knowledge of CPT/HCPCS/Revenue Codes, and willingness to travel if needed. The position offers a full-time schedule and comprehensive benefits.

Qualifications

• Must have AAPC CPC certification and be able to interpret and apply coding policies.
• Minimum of 3 years of medical and/or behavioral health coding experience, including medical record review and auditing.
• Knowledge of CPT, HCPCS, Revenue Codes, CMS 1500 and UB04 data elements.

Responsibilities

• Conduct comprehensive medical record reviews to ensure CPT/HCPCS/Revenue codes and modifiers match documentation.
• Provide written summaries of review findings.
• Articulate findings to investigators, leadership, and regulators as needed.
• Research and apply state or CMS guidelines to reviews with minimal support.
• Review cases with Medical Directors to validate decisions.
• Identify potential billing errors, abuse, and fraud.
• Maintain organized records and documentation.

Skills

CPC certification

Attention to detail

Strong communication

Education

AAPC CPC Certification

GED or High School diploma

Tools

Excel

Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the SIU, ensuring coding accuracy and compliant documentation across medical, behavioral health, transportation and other healthcare providers.

The role requires CPC certification, 3+ years of coding experience with record review and auditing, knowledge of CPT/HCPCS/Revenue Codes, and willingness to travel if needed. The position offers a full-time schedule and comprehensive benefits.