Sentara Health

AvMed, a division of Sentara Health Plans, seeks a Risk Adjustment Nurse/Coder in a hybrid role in Doral, FL. The position focuses on CMS/HHS risk adjustment coding, RADV audits, and ensuring accurate HCC capture in provider documentation. The ideal candidate holds an associate degree and relevant coding certifications, with 2 years of medical coding experience and familiarity with ICD-10-CM guidelines. #J-18808-Ljbffr

City/State Doral, FL Work Shift First (Days) Overview: AvMed, a division of Sentara Health Plans in the Florida market, is hiring a Risk Adjustment Nurse/Coder (RN/CPC, COC, CIC, CCS-P, CCS, RHIT, RHIA in Doral, FL! Status: Full-timepermanent position (40 hours) Standard working hours: 8am to 430pm EST, M-F Location: This is a hybrid position, 2 days onsite in AvMed Doral Office, 3470 NW 82nd Ave Suite 1100, Doral, FL 33122, and 3 days remote. Job Profile Summary Then Risk Adjustment Clinical Coder/Nurse 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...

Sentara Health in Charlottesville, VA is seeking a Senior Coding Specialist- Acute Care to support daily operations and ensure regulatory compliance within the HIM team. The role requires 2 years of coding experience and relevant certifications (CCS, CIC, CCA, RHIT, CPC, or COC). Remote work is preferred for candidates in Virginia or North Carolina, with competitive pay and comprehensive benefits. We offer market-competitive compensation including base pay, incentives, and a robust benefits #J-18808-Ljbffr

Sentara Health in Charlottesville, VA seeks a Senior Coding Specialist- Acute Care to support daily operations of the coding team and ensure accuracy and regulatory compliance. You will act as a technical resource and assist with quality initiatives within the unit. Required: minimum 2 years coding experience and CCS/CIC/CCA, RHIT, CPC, or COC certification(s). Remote work from Virginia or North Carolina may be available, with competitive hourly pay and comprehensive benefits. #J-18808-Ljbffr

Sentara Health in Charlottesville, VA seeks a Senior Coding Specialist- Acute Care to support daily operations, ensure quality and regulatory compliance, and assist in coordinating team work. The role requires 2 years of coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications, with 1 year HIM experience preferred. The position offers competitive pay ($34.92–$50.83 hourly) and a comprehensive benefits package, including medical, dental, vision, life and disability insurance, and 401(k) with #J-18808-Ljbffr

Sentara Health is seeking a Senior Coding Specialist- Acute Care to support daily operations and coding quality. The role emphasizes coordinating workflows, providing technical coding expertise, and ensuring regulatory compliance in a remote-friendly environment. Requirements include 2 years of coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications, with HIM experience preferred. High School diploma or equivalent is required. #J-18808-Ljbffr

Sentara Health is seeking a Senior Coding Specialist- Acute Care in Charlottesville, VA (First (Days) shift). The role supports daily operations, maintains quality, and provides technical expertise within the coding team. Requires 2 years coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications; 1 year HIM experience preferred. Remote work from VA/North Carolina may be available. Eligible candidates should have a High School Diploma or equivalent. #J-18808-Ljbffr

Sentara Health in Charlottesville, VA is seeking a Senior Coding Specialist- Acute Care to support daily operations and ensure quality in coding processes. You will assist leadership, provide technical guidance to team members, and help meet regulatory requirements. Requirements include 2 years of coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications; 1 year HIM experience preferred. Remote options from VA/NC supported. #J-18808-Ljbffr

Sentara Health is seeking a Senior Coding Specialist- Acute Care in Charlottesville, VA. The role involves assisting the Team Coordinator/Manager with daily operations, coordinating work, and ensuring quality and regulatory compliance within the department. The candidate will act as a technical resource for team members, participate in quality control, and support staff development. Required are 2+ years of coding experience and CCS, CIC, CCA, RHIT, CPC, or COC certifications; 1 year HIM #J-18808-Ljbffr

Sentara Health in Charlottesville, VA is hiring a Senior Coding Specialist- Acute Care. The role supports daily operations, quality and service, and regulatory compliance by providing technical coding expertise. Requires 2 years of coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications, with remote options in VA or NC. Eligible candidates may receive market-competitive base pay, incentives, and a comprehensive benefits package. #J-18808-Ljbffr

Sentara Health is seeking a Senior Coding Specialist- Acute Care to support daily operations and coding quality. The role emphasizes coordinating workflows, providing technical coding expertise, and ensuring regulatory compliance in a remote-friendly environment. Requirements include 2 years of coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications, with HIM experience preferred. High School diploma or equivalent is required. #J-18808-Ljbffr

Sentara Health in Charlottesville, VA, is seeking a Senior Coding Specialist- Acute Care for first shift. The role assists the Team Coordinator with daily operations, ensures quality and service, and supports regulatory compliance through technical coding expertise. Requirements include 2 years of coding experience and CCS, CIC, CCA, RHIT, CPC, or COC certifications; a high school diploma is required. Virginia or North Carolina remote work is preferred. #J-18808-Ljbffr

Sentara Health in Charlottesville, VA is seeking a Senior Coding Specialist- Acute Care to support daily operations and ensure quality in coding processes. You will assist leadership, provide technical guidance to team members, and help meet regulatory requirements. Requirements include 2 years of coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications; 1 year HIM experience preferred. Remote options from VA/NC supported. #J-18808-Ljbffr

Work Shift Multiple shifts available Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time, permanent position (40 hours) Location: This position is remote for candidates that live in the following states: With travel to Virginia Beach 1x a year. Responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, member, and broker interactions involving the full range of products. Responsible for contributing to the review of the quality of pharmacy, physician, ancillary and hospital based coding in routine desk audits as well as occasional on-site audits. Contribute to the review of reimbursement systems relating to health insurance claims processing and ensures adherence to policies and procedures for its various product offerings. Triage and prioritize leads/member complaints from internal sources. Assist in...

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

## 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 Charlottesville, VA is seeking a Senior Coding Specialist- Acute Care to support daily operations and ensure regulatory compliance within the HIM team. The role requires 2 years of coding experience and relevant certifications (CCS, CIC, CCA, RHIT, CPC, or COC). Remote work is preferred for candidates in Virginia or North Carolina, with competitive pay and comprehensive benefits. We offer market-competitive compensation including base pay, incentives, and a robust benefits #J-18808-Ljbffr

Sentara Health in Charlottesville, VA is seeking a Senior Coding Specialist- Acute Care to support daily operations and ensure regulatory compliance within the HIM team. The role requires 2 years of coding experience and relevant certifications (CCS, CIC, CCA, RHIT, CPC, or COC). Remote work is preferred for candidates in Virginia or North Carolina, with competitive pay and comprehensive benefits. We offer market-competitive compensation including base pay, incentives, and a robust benefits #J-18808-Ljbffr

Sentara Health is seeking a Senior Coding Specialist- Acute Care in Charlottesville, VA. The role supports daily operations, quality assurance, and coordination of work within the HIM coding team, ensuring regulatory compliance and service excellence. The position requires 2 years of coding experience and CCS, CIC, CCA, RHIT, CPC, or COC certification(s). Remote work is preferred in Virginia or North Carolina with competitive benefits and a comprehensive compensation package. #J-18808-Ljbffr

Sentara Health in Charlottesville, VA is seeking a Senior Coding Specialist- Acute Care to support daily operations and ensure regulatory compliance within the HIM team. The role requires 2 years of coding experience and relevant certifications (CCS, CIC, CCA, RHIT, CPC, or COC). Remote work is preferred for candidates in Virginia or North Carolina, with competitive pay and comprehensive benefits. We offer market-competitive compensation including base pay, incentives, and a robust benefits #J-18808-Ljbffr

Sentara Health is seeking a Senior Coding Specialist- Acute Care in Charlottesville, VA (First (Days) shift). The role supports daily operations, maintains quality, and provides technical expertise within the coding team. Requires 2 years coding experience and CCS/CIC/CCA/RHIT/CPC/COC certifications; 1 year HIM experience preferred. Remote work from VA/North Carolina may be available. Eligible candidates should have a High School Diploma or equivalent. #J-18808-Ljbffr

Sentara Health in Charlottesville, VA seeks a Senior Coding Specialist- Acute Care who will support daily operations, ensure quality and service, and help meet regulatory requirements. You will serve as a technical resource for the coding team and contribute to process improvements. The role requires 2 years of coding experience and CCS, CIC, CCA, RHIT, CPC, or COC certifications; remote work from VA or NC may be considered for eligible candidates. #J-18808-Ljbffr

Sentara Health is seeking a Senior Coding Specialist- Acute Care in Charlottesville, VA. The role supports daily operations, ensures regulatory compliance, and provides technical guidance to the coding team. A minimum of 2 years coding experience with CCS/CIC/CCA/RHIT/CPC/ COB certification is required, with 1 year HIS experience preferred. Remote work in VA/NC is preferred. The position offers market-competitive pay and a robust benefits package, including health, dental, vision, life, #J-18808-Ljbffr

Work Shift Multiple shifts available Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator/Certified Professional Coder (CPC) Remote! Status: Full-time, permanent position (40 hours) Location: This position is remote for candidates that live in the following states: With travel to Virginia Beach 1x a year. Responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, member, and broker interactions involving the full range of products. Responsible for contributing to the review of the quality of pharmacy, physician, ancillary and hospital based coding in routine desk audits as well as occasional on-site audits. Contribute to the review of reimbursement systems relating to health insurance claims processing and ensures adherence to policies and procedures for its various product offerings. Triage and prioritize leads/member complaints from internal sources. Assist in the...