Waste & Error Coding Manager - Elevate Claims Integrity

CVS Health Corporation; Phoenix (AZ); Hybrid; USD 54,000 - 146,000; Full time

Benefits offered by this job

Hybrid work environment

Bonus eligibility

Comprehensive benefits

Job summary

CVS Health Corporation is seeking a Waste & Error Certified Coding Manager to lead the Certified Coding Analysts and W&E Team Lead roles responsible for medical claim reviews and audits. The manager drives accuracy, compliance, and outcome delivery while guiding staff development and performance.

The role partners with senior leadership, Medical Directors, Legal, Compliance, Analytics, and Operations to improve efficiency and prevent waste, with a hybrid work arrangement.

Qualifications

• Active AAPC CPC/CCS/RHIT or RN license with coding/auditing experience.
• 5+ years in medical coding, reviews, auditing, or payment integrity.
• 2+ years in people leadership or team management.
• Experience leading coding quality programs and workload oversight.
• Strong CPT/HCPCS/ICD-10 knowledge and reimbursement rules.
• Experience with policy research and applying CMS/state rules.
• Proficiency with Excel and Word for analytics.

Responsibilities

• Lead and develop Certified Coding Analysts and Senior Analysts.
• Set performance goals, productivity standards, and quality requirements.
• Oversee hiring, onboarding, training, and retention for the coding team.
• Deliver technical coaching, feedback, and continuous education.
• Oversee coding audits, reviews, reconsiderations, and appeals.
• Manage workloads, queues, and service level expectations.
• Ensure compliance with coding guidelines and reimbursement rules.
• Report performance results to leadership and stakeholders.

Skills

Leadership & coaching

Communication

Problem solving

Attention to detail

Time management

Education

Active AAPC CPC, CCS, RHIT or RN license

RN license (if applicable)

Bachelor's degree or higher

Tools

EncoderPro

Microsoft Excel

Microsoft Word

Job description

CVS Health Corporation is seeking a Waste & Error Certified Coding Manager to lead the Certified Coding Analysts and W&E Team Lead roles responsible for medical claim reviews and audits. The manager drives accuracy, compliance, and outcome delivery while guiding staff development and performance.

The role partners with senior leadership, Medical Directors, Legal, Compliance, Analytics, and Operations to improve efficiency and prevent waste, with a hybrid work arrangement.