CVS Health is seeking a Certified Coding Analyst to perform medical claim reviews for waste and error, ensuring coding accuracy and compliance with state, CMS and company requirements. The analyst reviews medical records to determine correct CPT/HCPCS coding and documentation.
Key duties include auditing CPT/HCPCS and modifiers, applying guidelines, discussing cases with Medical Directors, researching coding policies, identifying billing errors or fraud, and summarizing findings clearly.
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