SIU Medical Coding & Compliance Analyst

Voices for Voices; Baton Rouge (LA); Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). You will ensure CPT/HCPCS accuracy and appropriate documentation across providers, state and federal guidelines, and detect billing anomalies.

In this full-time role, you will communicate findings to investigators and leadership, maintain case files, and contribute to savings opportunities while staying current with coding changes and payer requirements.

Qualifications

• Must hold AAPC CPC certification and actively maintain credentials.
• Minimum 3 years of medical/behavioral health coding with 1–2 years of review experience.
• Knowledge of CPT, HCPCS, Revenue Codes, CMS 1500/UB04 data elements.
• Ability to interpret coding policies and communicate findings clearly.

Responsibilities

• Conduct comprehensive medical record reviews for coding accuracy and documentation.
• Provide written summaries of findings and articulate results to investigators and leaders.
• Apply state and CMS guidelines to review cases with guidance from Medical Directors.
• Identify billing errors, potential fraud, and opportunities for cost savings.
• Maintain records and follow workflows to meet performance metrics.

Skills

CPC coding

CPT

HCPCS

Revenue Codes

Documentation auditing

Medicare/Medicaid

MS Excel

MS Word

Education

AAPC CPC certification

GED or High School diploma

Tools

MS Excel

MS Word

Job description

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). You will ensure CPT/HCPCS accuracy and appropriate documentation across providers, state and federal guidelines, and detect billing anomalies.

In this full-time role, you will communicate findings to investigators and leadership, maintain case files, and contribute to savings opportunities while staying current with coding changes and payer requirements.