Jul 27, 2026

Certified Professional Coder: Audit & Compliance Specialist

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 coding compliance, review medical records, and verify adherence to state, federal, and company policies. Strong communication with investigators and regulators is essential. Responsibilities include auditing records for CPT/HCPCS alignment, researching guidelines, and identifying potential billing issues or fraud. #J-18808-Ljbffr