Waste & Error Coding Manager — Lead Audit & Quality

CVS Health Corporation; Center Square (PA); Hybrid; USD 54,000 - 146,000; Full time

Job summary

CVS Health Corporation in the United States is seeking a Waste & Error Certified Coding Manager to lead the Certified Coding Analysts and oversee audit operations, ensuring accurate CPT/HCPCS/ICD-10 coding and adherence to regulatory requirements.

You will develop the team, manage workload, drive process improvements, and partner with Legal, Compliance, Medical Directors and leadership to deliver high-quality outcomes.

Qualifications

• Active AAPC Certified Coder CPC, CCS, RHIT or RN license w/significant coding/auditing experience.
• 5+ years in medical coding, claims review, auditing, payment integrity.
• 2+ years in people leadership including performance management.
• Experience leading coding quality programs and workload oversight.
• Strong knowledge of CPT, HCPCS, ICD-10, CMS 1500, UB-04 and reimbursement requirements.
• Experience researching and applying state/federal policies.
• Proven ability to manage multiple priorities and meet deadlines.
• Excellent written and verbal communication skills.
• Proficiency with Excel and Word.

Responsibilities

• Lead and develop the Certified Coding Analysts and Senior Analysts.
• Set performance goals, productivity standards, and quality requirements.
• Oversee hiring, onboarding, training, and development for the coding team.
• Provide operational oversight for medical record reviews and coding audits.
• Monitor workload, queues, and service level expectations.
• Ensure adherence to coding guidelines and regulatory requirements.
• Partner with senior leadership and cross-functional teams.

Skills

Medical coding expertise

People leadership

Quality program leadership

Analytical problem solving

Communication skills

Excel proficiency

Education

High school diploma or GED

Tools

Excel

Word

EncoderPro / coding tools

Job description

CVS Health Corporation in the United States is seeking a Waste & Error Certified Coding Manager to lead the Certified Coding Analysts and oversee audit operations, ensuring accurate CPT/HCPCS/ICD-10 coding and adherence to regulatory requirements.

You will develop the team, manage workload, drive process improvements, and partner with Legal, Compliance, Medical Directors and leadership to deliver high-quality outcomes.