SIU Medical – Behavioral Health Coding Analyst

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🔥 8 minutes ago

🏈 Alabama, Arizona, +30 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🌾 Nebraska – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🍑 Georgia – Remote

💵 $43.9k - $76.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Conduct comprehensive medical record reviews to verify CPT/HCPCS/Revenue codes and modifiers against documentation • Provide detailed written summaries of medical record review findings • Articulate findings to investigators, leadership, law enforcement, legal counsel, providers, and state regulators • Research and apply state or CMS guidelines • Review and discuss cases with Medical Directors • Assist with investigative research on coding questions and state and federal policies • Identify potential billing errors, abuse, and fraud • Identify potential savings opportunities for prepayment review • Maintain records, files, and documentation • Follow department workflows and meet daily performance metrics • Maintain current coding knowledge regarding compliance and reimbursement changes

🎯 Requirements

• AAPC Certified Professional Coder (CPC) certification • Minimum of 3 years of experience in medical and/or behavioral health professional coding • At least 1–2 years of current professional coding experience, including medical record review and documentation auditing • Knowledge of CPT, HCPCS, and Revenue Codes • Knowledge of CMS 1500 and UB04 data elements • Ability to interpret and consistently apply coding policies and guidelines • Experience with Microsoft products, including Excel and Word • Ability to travel for the role, if needed • GED or High School diploma

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being

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