SIU Medical Coding Auditor & Compliance Specialist

Pennsylvania Psychological Association; Harrisburg (Dauphin County); On-site; USD 44,000 - 94,000; Full time

Job summary

CVS Health is seeking a qualified Certified Professional Coder (CPC) to perform medical claim reviews for the SIU. The role entails ensuring correct coding, documenting findings, and communicating with investigators and regulators. Requires CPC, 3+ years of coding experience, and travel ability.

Responsibilities include reviewing CPT/HCPCS codes, preparing written summaries, and applying state and CMS guidelines with minimal supervision. Full-time with 40 hours weekly.

Qualifications

• Must have CPC certification and 3+ years in medical/behavioral health coding, with at least 1–2 years in records review/audit.
• Proficient with CPT/HCPCS/Revenue Codes, CMS 1500/UB04, and coding policies.
• Able to interpret and apply coding guidelines; strong written/verbal communication.

Responsibilities

• Conduct comprehensive medical record reviews to verify CPT/HCPCS/Revenue Code accuracy against documentation.
• Provide detailed written summaries of review findings for investigators and leadership.
• Articulate findings to cross-functional teams including investigators, law enforcement, and regulators.

Skills

Medical coding knowledge

Record review

Auditing

Verbal communication

Written communication

Attention to detail

Travel flexibility

Education

AAPC CPC certification

GED or high school diploma

Tools

Microsoft Excel

Microsoft Word

Job description

CVS Health is seeking a qualified Certified Professional Coder (CPC) to perform medical claim reviews for the SIU. The role entails ensuring correct coding, documenting findings, and communicating with investigators and regulators. Requires CPC, 3+ years of coding experience, and travel ability.

Responsibilities include reviewing CPT/HCPCS codes, preparing written summaries, and applying state and CMS guidelines with minimal supervision. Full-time with 40 hours weekly.