Atlanta, GA · On-site
$43K - $102K/yr
The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements ...
New
Atlanta, GA · On-site
$43K - $102K/yr
The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements ...
New
Cumming, GA · On-site
$52K - $68K/yr
... Code of Professional Practice. Maintains certification in good standing with the Board of Court ... two medical plans offered by Aetna and a plan offered by Kaiser Permanente. * Aetna Choice POS ...
Cumming, GA · On-site
$52K - $68K/yr
... Code of Professional Practice. Maintains certification in good standing with the Board of Court ... two medical plans offered by Aetna and a plan offered by Kaiser Permanente. * Aetna Choice POS ...
Roswell, GA · On-site
$18 - $24.50/hr
The ideal candidate will have a strong understanding of medical insurance processes, payer policies ... 10, and HCPCS coding. * Previous experience working with specific payers (e.g., Aetna ...
Quick apply
Roswell, GA · On-site
$18 - $24.50/hr
The ideal candidate will have a strong understanding of medical insurance processes, payer policies ... 10, and HCPCS coding. * Previous experience working with specific payers (e.g., Aetna ...
$4.47 - $7.64
0% of jobs
$7.64 - $10.81
0% of jobs
$10.81 - $13.99
0% of jobs
$13.99 - $17.16
0% of jobs
$17.16 - $20.33
0% of jobs
$21.42 is the 25th percentile. Wages below this are outliers.
$20.33 - $23.51
73% of jobs
$26.29 is the 75th percentile. Wages above this are outliers.
$23.51 - $26.68
2% of jobs
$26.68 - $29.86
8% of jobs
$29.86 - $33.03
8% of jobs
$33.03 - $36.20
4% of jobs
$36.20 - $39.38
4% of jobs
$4
$25
$39
An Aetna Medical Coding job involves reviewing medical records and assigning standardized codes for diagnoses, procedures, and treatments. Coders ensure accuracy in billing and insurance claims processing while complying with industry regulations like ICD-10, CPT, and HCPCS codes. They work closely with healthcare providers and insurance teams to facilitate proper reimbursement and minimize claim denials. Strong attention to detail and knowledge of medical terminology are essential for success in this role.
A typical day as an Aetna Medical Coding professional involves reviewing patient medical records, assigning appropriate diagnostic and procedural codes, and ensuring documentation meets established coding and billing standards. You'll frequently collaborate with healthcare providers to clarify documentation, resolve coding discrepancies, and support claims accuracy. The role often includes maintaining up-to-date knowledge of coding guidelines and insurance policies to reduce errors and denials. Working as part of a team, you'll help ensure smooth billing processes and accurate reimbursement for healthcare services.
To thrive in Aetna Medical Coding, you need a strong understanding of medical terminology, anatomy, coding guidelines, and insurance processes, often supported by a certification such as CPC, CCS, or CCA. Familiarity with coding software (e.g., ICD-10, CPT, and HCPCS systems), electronic health records (EHRs), and related billing systems is essential. Attention to detail, analytical thinking, and effective communication are valuable soft skills in this position. Mastery of these skills ensures accurate claims processing, compliance with regulations, and smooth coordination with healthcare providers and payers.
The most popular types of Aetna Medical Coding jobs in Georgia are:
For Aetna Medical Coding jobs in Georgia, the most frequently searched job titles are:
The top searched job categories for Aetna Medical Coding jobs in Georgia are:
Cities in Georgia with the most Aetna Medical Coding job openings:
Atlanta, GA • On-site
$43K - $102K/yr
Other
Medical, Dental, Vision, Retirement, PTO
Posted 2 days ago
New
5.8
Based on 4,370 frontline employees who took The Breakroom Quiz
92nd of 113 rated pharmacies
We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.
Position Summary
The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends.
Activities include:
Conduct a comprehensive medical record review to ensure billing is consistent with medical record.
Provide detailed written summary of medical record review findings.
Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc.
Review and discuss cases with Medical Directors to validate decisions.
Assist with investigative research related to coding questions, state and federal policies.
Identify potential billing errors, abuse, and fraud.
Identify opportunities for savings related to potential cases which may warrant a prepayment review.
Maintain appropriate records, files, documentation, etc.
Ability to travel for meetings and potential to testify
Required Qualifications
AAPC Coding certification - Certified Professional Coder (CPC)
3+ years of experience in medical coding or documentation auditing.
Strong knowledge of standard industry coding guides and guidelines including CPT, HCPCS, Revenue Codes, CMS 1500 and UB04 data elements
Experience with researching coding, state regulations and policies.
Working experience with Microsoft Excel
Preferred Qualifications
2 years or more previous experience with Behavioral Health coding/auditing of records
Prior auditing experience
Excellent analytical skills
Excellent communication skills
Strong attention to detail and ability to review and interpret data
Education
GED or equivalent
AAPC Certified Professional Coder Certification (CPC)
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$43,888.00 - $102,081.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .
We anticipate the application window for this opening will close on: 10/17/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.
Get the full story on Breakroom
Sourced by ZipRecruiter
Health care and social assistance and retail
10,000+ Employees
Woonsocket, RI, US
