• Senior Certified Professional…

    CVS Health (Richmond, VA)
    …more compassionate. And we do it all with heart, each and every day. The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the ... Special Investigations Unit (SIU) to ensure compliance with coding...and reimbursement. **Required Qualifications** + AAPC Coding certification - Certified Professional Coder (CPC) +… more
    CVS Health (11/25/25)
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  • Certified Professional Coder…

    CVS Health (Richmond, VA)
    …And we do it all with heart, each and every day. **Position Summary** The Certified Professional Coder (CPC) will perform medical claim reviews to ensure ... and potential to testify **Required Qualifications** + AAPC Coding certification - Certified Professional Coder (CPC) + 3+ years of experience in medical… more
    CVS Health (11/12/25)
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  • Senior Investigator, Special Investigations…

    CVS Health (Richmond, VA)
    …to travel approximately 10% of time for business purposes. **Preferred Qualifications** + Certified Professional Coder (CPC), AHFI, CFE + Knowledge of ... are seeking an experienced Senior Healthcare Fraud Investigator to join our Special Investigations Unit (Aetna SIU), dedicated to a specific self-funded plan… more
    CVS Health (11/19/25)
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  • Special Investigation Unit Lead Review…

    CVS Health (Richmond, VA)
    …to provide testimony if needed. + Experience with Excel. **Preferred Qualifications** + Certified Professional Coder + Knowledge of CVS/Aetna's policies and ... be work from home anywhere in the United States. **Position Summary** The Special Investigations Unit (SIU) is looking for an analytically driven individual who is… more
    CVS Health (11/19/25)
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  • Revenue Integrity Nurse Auditor

    Childrens Hospital of The King's Daughters (Chesapeake, VA)
    …as a Registered Nurse or Registered Nurse holding a valid Compact State license. + Certified Professional Coder required. + Certified Outpatient Coder ... appropriateness of services. + Conducts compliance, defense, LifeNet and special focus audits and reports findings. + Serves as...Minimum of 3 years of clinical experience as a Certified Professional Coder required. +… more
    Childrens Hospital of The King's Daughters (10/23/25)
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  • Payment Integrity Clinician

    Highmark Health (Richmond, VA)
    …Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + Demonstrated ability ... SUMMARY** This job requires the ability to identify issues related to professional and facility provider claims data including determining appropriateness of code… more
    Highmark Health (11/14/25)
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  • Clinical Fraud Investigator II - Registered Nurse…

    Elevance Health (Richmond, VA)
    …Requirements:** + Requires an Associate Degree in Nursing and/or current certification as a Certified Professional Coder (AAPC or AHIMA) and minimum of 4 ... necessary to aid in investigations. + Collaborates with the Special Investigation Unit and other internal areas on matters...our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors… more
    Elevance Health (11/04/25)
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  • Supervisor Medical Coding

    CenterWell (Richmond, VA)
    …years of billing and coding experience in a health care organization + CPC ( Certified Professional Coder ) Certification required through AAPC or CSS ... but travel will be required; <25% travel + No special scheduling; hours are clinic hours M-F 8-5 Central...we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer**… more
    CenterWell (10/31/25)
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