CVS Health
Senior Certified Professional Behavioral Health Coder, Special Investigations Unit
$47K–$112K
CT - Work from home · Remote/Hybrid · Senior · Full-time · Posted Oct 22, 2026
- Experience
- 3+ years of experience in Behavioral Health medical coding or documentation auditing.
- Education
- AAPC Certified Professional Coder Certification (CPC); GED or High School diploma.
About the job
Reviews healthcare claims and medical records for the Special Investigations Unit to validate coding, identify billing errors or potential fraud, and communicate findings.
What you'll do
- Audit medical records and claims for coding accuracy, documentation, and compliance with applicable guidelines.
- Document and communicate review findings; collaborate with investigators, medical directors, leadership, and external stakeholders.
- Mentor coders, research coding policies, and support SIU casework and team operations.
What they ask for
- AAPC Certified Professional Coder (CPC) certification.
- 3+ years of experience in Behavioral Health medical coding or documentation auditing.
- Knowledge of CPT, HCPCS, ICD-10, CMS 1500, and UB04 data elements.
- Experience researching coding and policies, auditing others’ work, providing feedback, and mentoring; Microsoft products including Excel and Word.
Nice to have
- Licensed Clinical Social Worker (LCSW), Licensed Independent Social Worker (LISW), Licensed Master Social Worker (LMSW), or Licensed Professional Counselor (LPC).
- Excellent communication and analytical skills; strong attention to detail and ability to interpret data.
Pay
$46,988.00 - $112,200.00 USD (base salary)
Tools
CPT, HCPCS, ICD-10, CMS 1500, UB04, Microsoft products, Excel, Word
Model-written summary · the original posting is authoritative