• Certified Professional Coder

    CVS Health (Augusta, ME)
    …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 (Augusta, ME)
    …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 (Augusta, ME)
    …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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  • Payment Integrity Clinician

    Highmark Health (Augusta, ME)
    …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 (South Portland, ME)
    …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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