2 jobs found in Sanford

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

CVS Health is seeking a Certified Professional Coder (CPC) for its Special Investigations Unit in Sanford, ME. You will perform medical claim reviews, determine correct coding, assess documentation, and ensure compliance with state and federal guidelines. The role involves communicating findings to investigators and leadership, identifying billing errors, and contributing to prepayment reviews. A CPC with 3+ years of coding/auditing, CPT/HCPCS knowledge, and Excel/Word skills is required. #J-18808-Ljbffr