Waste & Error Coding Manager — Lead Audits & Compliance

CVS Health Corporation; Concord (NH); Hybrid; USD 54,000 - 146,000; Full time

Benefits offered by this job

Hybrid work environment

Bonus eligibility

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. You will drive medical claim reviews, coding audits, and identify opportunities for improved accuracy and payment integrity.

The role includes staffing, performance management, and collaboration with senior leadership, Medical Directors, Legal, Compliance, Analytics and other partners.

Qualifications

• Certified coder with CPC/CCS/RHIT or RN license is required.
• 5+ years in medical coding, claims review, auditing, or payment integrity.
• 2+ years of people leadership or team management experience.
• Experience leading coding quality programs, productivity management, and remediation.
• Strong knowledge of CPT, HCPCS, ICD-10, CMS 1500, UB-04, and reimbursement rules.
• Experience researching and applying state, federal, CMS, and organizational policies.
• Ability to manage multiple priorities, meet deadlines, and communicate results clearly.
• Proficiency with Excel and Word; ability to interpret operational data.

Responsibilities

• Lead, coach, and develop Certified Coding Analysts and Senior Analysts.
• Set performance goals and quality standards, and manage staffing and onboarding.
• Oversee coding audits, work queues, and production targets.
• Ensure adherence to coding guidelines and regulatory requirements.
• Escalate complex cases and coordinate with Medical Directors and Legal.
• Drive continuous improvement in processes and systems.

Skills

People leadership

Communication skills

Coding knowledge CPT/HCPCS/ICD-10

Attention to detail

Project management / multitasking

Education

Active AAPC Certified Coder CPC, CCS, RHIT or RN license

High school diploma or GED

Tools

EncoderPro or equivalent coding research tool

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. You will drive medical claim reviews, coding audits, and identify opportunities for improved accuracy and payment integrity.

The role includes staffing, performance management, and collaboration with senior leadership, Medical Directors, Legal, Compliance, Analytics and other partners.