• Certified Professional Coder

    CVS Health (Woonsocket, RI)
    …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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  • Investigator 1 - FWA Prepayment Review

    Point32Health (Canton, MA)
    …Qualifications - what you need to perform the job Certification and Licensure + Certified Professional Coder ("CPC"); Certified Fraud Examiner ("CFE") ... Summary** The Investigator I is an essential team member of the Special Investigation Unit ("SIU") responsible for leading complex provider investigations related to… more
    Point32Health (10/31/25)
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  • Payment Integrity Clinician

    Highmark Health (Providence, RI)
    …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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