• Certified Professional Coder

    CVS Health (Phoenix, AZ)
    …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 (11/11/25)
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  • Senior Investigator, Special Investigations…

    CVS Health (Phoenix, AZ)
    …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 (Phoenix, AZ)
    …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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  • Investigator, Coding Special Investigative…

    Molina Healthcare (Phoenix, AZ)
    …Association** Licensed registered nurse (RN), Licensed practical nurse (LPN) and/or Certified Coder (CPC, CCS, and/or CPMA) **Preferred Education** Bachelor's ... Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional designations preferred To all current… more
    Molina Healthcare (11/20/25)
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  • Payment Integrity Clinician

    Highmark Health (Phoenix, AZ)
    …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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