24 jobs found in Virginia Beach

Medical Coding Professional 2The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding workflows, and ensure agreement on organizational documentation and coding standards, while collaborating with STARS leaders and champions to identify STARS gaps and deficiencies.The...

Coding Specialist (Part-Time)At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.Primary DutiesPerforming audit functions for the identified encounters in a timely and accurate manner.Generating well-written deliverables and audit work papers.Outstanding verbal communication skills.Outstanding...

Certified CoderAt Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.Requirements3+ years of direct experience in medical coding, medical billing, and/or coding quality assurance/auditing in a healthcare environment, including ICD-10-CM/PCS, CPT/HCPCS, and DRG/APR-DRG coding systemsActive coding...

Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA! Hours: Monday - Friday, 8:00AM -5:00PM, dayshift. This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration. Overview Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record...

Signature Performance is seeking a remote Medical Coder for Surgery/Anesthesia. You will review medical records to assign accurate diagnoses and procedures, ensuring coding compliance and correct sequencing for proper reimbursement. Must have 2+ years of medical coding experience, and credentials such as RHIT/RHIA/CCS/CCS-P/CPC/CCA. Work is nationwide remote; responsibilities include reviewing documents, abstracting patient data, and maintaining coding quality and productivity metrics. #J-18808-Ljbffr

Job Title Tidewater Physicians for Women is seeking an experienced and certified OB/GYN medical biller. We offer a competitive salary and excellent benefits. Qualifications Experience in medical billing for an OB/GYN medical practice is required. Experience with medical coding systems (ICD-10, ICD-9) is required. Proficiency in using medical office systems and software for billing purposes. Strong attention to detail and organizational skills are required. Knowledge of billing procedures of Medicare, Medicaid, and private insurers and understanding of financial billing requirements. Knowledge of organization structure, workflow and operating procedures within a high-volume medical billing environment. Knowledge of Federal, State and payer regulations regarding medical billing compliance. Knowledge of mainframe-based medical billing and editing systems. Skill in keyboarding and knowledge of Microsoft Office programs. Skill in establishing and maintaining...

Medical Coding Specialist I Comprehensive understanding of the entire billing cycle, medical terminology, coding, charge entry, insurance adjudication, contractual agreements, payment posting, statements and collections. This is a HYBRID position--one day per week office time is required to fulfill administrative tasks for Coding Denials work. Candidate must be close to either Sentara Rockingham Memorial Hospital or Sentara Martha Jefferson Hospital Charlottesville Required: minimum of 3 years of multi-specialty coding experience with Current Procedural Terminology (CPT), International Classification of Diseases version 10 (ICD-10), Heath Care Common Procedure Coding System (HCPCS) and Modifier Coding preferred. CCS or CPC required Education High School Diploma or equivalent Certification/Licensure CCS or CPC Coding Certification (Required) Experience minimum of 3 years of multi-specialty coding experience with Current Procedural Terminology (CPT), International...

This is a remote based position. Applicants can be located nationwide Back Medical Billing Specialist II #2878 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are someone who has a strong understanding of medical billing processes, payer guidelines, and attention to detail. We need someone who can ensure proper claim details, billing compliance, and timely claims resolution to support the organization's financial goals. In the role of Medical Billing Specialist II, you will be responsible for accurately preparing and submitting medical claims to appropriate payers. Tell us about your experience with Medical Billing or in Revenue Cycle Operations. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you?...

Job TitleRisk CoderLocationVirginia Beach, VAWork ShiftFirst (Days)Job DescriptionPerforms compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs vendor quality...

Signature Performance is seeking a Medical Billing Specialist II to handle claims processing, coding verification, and timely submissions for diverse payer networks. The role emphasizes accuracy, compliance with CPT/ICD-10/HCPCS, and collaboration with clinical teams to resolve billing issues. Applicants should have at least 2 years in medical billing, familiarity with EHR systems (Epic, Cerner, Meditech, NextGen), and strong communication skills. #J-18808-Ljbffr

Sentara Health is seeking a Medical Coding Specialist II in Virginia Beach to perform accurate and compliant coding across multiple specialties. The role supports the revenue cycle from coding to collections and requires strong attention to regulatory guidelines. The ideal candidate has CPC or CCS certification, at least 5 years of coding experience, and familiarity with Epic, GECB, or Allscripts. The base pay ranges with additional incentives based on performance and shift differentials. #J-18808-Ljbffr

## Risk Adjustment CoderApplyremote type: Hybridlocations: SMG Administrationtime type: Full timeposted on: Posted Todayjob requisition id: JR-103351**City/State**Virginia Beach, VA**Work Shift**First (Days)**Overview:**# **Overview**Performs compliance activities focused on risk adjustment in accordance with Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS). Performs prospective/retrospective medical record reviews (MMR) & CMS/HHS Risk Adjustment Data Validation (RADV) audits. Reviews provider coding for professional & inpatient/outpatient services to ensure capture of diagnostic conditions supported within the provider's documentation for CMS/HHS Hierarchical Condition Categories (HCC). Supports risk adjustment data validation (RADV), medical record retrieval, vendor coding audits, provider engagement, & all risk adjustment ICD-10-CM coding-related activities. Conducts annual risk assessments, training,...

Sentara Health in Virginia Beach, VA is seeking a Medical Coding Specialist II to perform accurate and compliant coding across multiple specialties, supporting revenue cycle operations and ensuring timely, accurate billing. The ideal candidate has at least 5 years of coding experience, CPC or CCS certification, familiarity with Epic, GECB, or Allscripts, and a strong grasp of the full revenue cycle from terminology to collections. #J-18808-Ljbffr

Sentara Health Plans in Virginia Beach, VA is seeking a Risk Adjustment Coder to perform compliance activities related to CMS/HHS risk adjustment and RADV audits. You will review professional and facility coding to ensure accurate HCC capture and support vendor and internal audits. The role requires an Associate degree or 4 years of coding experience, knowledge of ICD-10-CM guidelines, and CRC certification within two years. #J-18808-Ljbffr

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2814 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced...

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly changing healthcare...

Become a part of our caring community We are looking for a consultative coding professional to provide medical coding expertise and support to IPA affiliates nationwide. The IPA Consultative Coding Professional will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value‑based care initiatives. They will analyze trends, triage, answer questions in real‑time, research and interpret coding guidelines, and respond to inquiries and issues. Assignment will include a panel of up to 30 providers within a defined market or region. The professional will deliver ongoing education, support coding workflows, and ensure agreement on documentation and coding standards, while collaborating with STARS leaders and champions to identify gaps and deficiencies. They will support IPA‑affiliated clinicians—physicians and advanced practice providers—to ensure documentation supports accurate diagnostic coding...

Medical Coding Specialist I Comprehensive understanding of the entire billing cycle, medical terminology, coding, charge entry, insurance adjudication, contractual agreements, payment posting, statements and collections. This is a HYBRID position--one day per week office time is required to fulfill administrative tasks for Coding Denials work. Candidate must be close to either Sentara Rockingham Memorial Hospital or Sentara Martha Jefferson Hospital Charlottesville. Required: minimum of 3 years of multi-specialty coding experience with Current Procedural Terminology (CPT), International Classification of Diseases version 10 (ICD-10), Health Care Common Procedure Coding System (HCPCS) and Modifier Coding preferred. CCS or CPC required Education High School Diploma or equivalent Certification/Licensure CCS or CPC Coding Certification (Required) Experience minimum of 3 years of multi-specialty coding experience with Current Procedural Terminology (CPT), International...

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:OverviewThe Medical Coding Specialist II is responsible for performing accurate and compliant coding activities while supporting revenue cycle operations across multiple specialties. This role requires a comprehensive understanding of the entire billing cycle, including medical terminology, coding principles, charge entry, insurance adjudication, contractual agreements, payment posting, statements, and collections. The ideal candidate demonstrates strong analytical skills, coding accuracy, and attention to detail while ensuring compliance with regulatory guidelines and organizational standards. This role collaborates closely with providers, clinical teams, and revenue cycle partners to support operational excellence, optimize reimbursement, and maintain coding integrity across healthcare services.EducationHigh School Diploma or Equivalent (Required)Certification/LicensureCertified Professional Coder (CPC) or Certified...

Medical Coding Specialist I Comprehensive understanding of the entire billing cycle, medical terminology, coding, charge entry, insurance adjudication, contractual agreements, payment posting, statements and collections. This is a HYBRID position--one day per week office time is required to fulfill administrative tasks for Coding Denials work. Candidate must be close to either Sentara Rockingham Memorial Hospital or Sentara Martha Jefferson Hospital Charlottesville Required: minimum of 3 years of multi-specialty coding experience with Current Procedural Terminology (CPT), International Classification of Diseases version 10 (ICD-10), Heath Care Common Procedure Coding System (HCPCS) and Modifier Coding preferred. CCS or CPC required Education High School Diploma or equivalent Certification/Licensure CCS or CPC Coding Certification (Required) Experience minimum of 3 years of multi-specialty coding experience with Current Procedural Terminology...