19 coder jobs found in Raleigh

CVS Health is seeking a Healthcare Records Auditor to perform audit and abstraction of medical records for CMS risk adjustment, ensuring accuracy and regulatory compliance. You will review physician documentation, assign diagnoses, and verify support in records, working to meet strict project deadlines while adhering to CMS and internal policies. This role emphasizes accuracy, accountability, and quality in a care-driven environment. #J-18808-Ljbffr

Medical Coding Specialist Perform dictionary coding in accordance with study specific coding conventions using MedDRA and WHO Drug within various coding systems. Manage end-to-end delivery of clinical data management coding responsibilities concurrently for single/multiple projects ensuring quality and timeliness. Provide leadership and mentorship to Medical Coding Specialists as needed. Create, review, and maintain guidance and training documentation for coding guidelines an accordance with ICH guidance, official coding guidelines and dictionary definitions. Responsibilities: Perform coding in accordance with study specific coding conventions as outlined in the Data Management Plan (DMP) Perform coding using MedDRA and WHO Drug of (eCRF) verbatim terms using various coding systems Provide independent review of coded data by ensuring consistent code assignment within a project by reviewing coding and re-assignment Responsible for medical coding review, synonym dictionaries...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. 1,500 Sign on Bonus We’re looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule,...

CVS Health is seeking a Certified Professional Coder to perform medical claim reviews for the Special Investigations Unit. The CPC will ensure coding compliance, review medical records, and identify billing irregularities across providers and plans. The role requires CPC certification, 3+ years in coding/auditing, and strong knowledge of CPT/HCPCS/ICD-10. A statewide or NC-based focus with thorough documentation and collaboration with Medical Directors is expected. #J-18808-Ljbffr

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. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) 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. Conduct a...

**Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. **ESSENTIAL RESPONSIBILITIES** + Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) + Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) + Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and...

Overview Serves as the senior member of the corporate coding team by providing extensive knowledge for timely and accurate coding and DRG assignment. Performs the function of coding, DRG assignment, collection of predefined indicators, and abstracting medical records. Provides timely and accurate ICD-10-CM and ICD-10-PCS codes for reimbursement and specific information for statistical purposes. Serves as a liaison between coders and CDS team on coding and documentation issues. Reviews SMART accounts on a daily basis as assigned. Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Licensure Registered Health Information Technician Required Registered Health Information Administrator Required Certified...

A healthcare organization seeks an Oncology Data Specialist for remote work focusing on cancer data abstraction and coding. The role requires a minimum of one year in a Cancer Registry position, adaptability to a changing work environment, and knowledge of coding in cancer registry software such as EPIC and CRStar. Ideal candidates will possess an Associate or Bachelor degree in an accredited program. #J-18808-Ljbffr

A leading healthcare provider is seeking a skilled Medical Records Outpatient Coder III. This remote position requires expertise in coding for emergency, same day surgery, and observation cases. The ideal candidate has a CCS certification and 5 years of outpatient coding experience. Flexible shifts are available, with the role focusing on accurate code assignment and collaboration across teams. Join us in a dynamic healthcare environment that values teamwork and excellence. #J-18808-Ljbffr

BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: PRN (as needed, non-benefit eligible) Shift: Flexible Days: Tuesday - Saturday OR Sunday - Thursday The Medical Records Outpatient Coder III will work remotely on a PRN (non-benefit eligible) basis. Responsibilities The Medical Records Outpatient Coder III reviews short stay focused encounters to accurately assign diagnosis and procedural codes-using ICD-10-CM and CPT-4 coding systems. Works in conjunction with various departments for missing documentation and monitors bill hold reports. Strong utilization of medical terminology and anatomy. Assists Manager/Director with mentoring/training of...

Direct Jobs is seeking a Senior Coder in Raleigh, North Carolina, providing expertise in accurate coding and DRG assignment. The role includes abstracting medical records and timely coding for reimbursement purposes. The ideal candidate will possess certifications as a Registered Health Information Technician, Certified Professional Coder, and a degree in Health Information Management. Join us to deliver quality healthcare services and support the community's health. #J-18808-Ljbffr

RCS Medical Coding Auditor page is loaded## RCS Medical Coding Auditorremote type: Hybridlocations: Raleigh, NCtime type: Full timeposted on: Posted 7 Days Agojob requisition id: JR10360**Position Summary**The **RCS Medical Coding Auditor** is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with **professional fee coding**, deep knowledge of **E/M, surgical, and modifier use**, and the ability to translate audit findings into actionable insights.**Key Responsibilities*** Perform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedback* Validate ICD‐10‐CM, CPT(R), HCPCS, and modifier assignment against clinical...

Baylor Scott & White Health is seeking a Coding Auditor I to perform coding quality audits and provide feedback to coders using ICD-10-CM/PCS, HCPCS, CPT and related references to ensure accurate classification and billing. The role collaborates with Clinical Documentation Specialists, abstracts data, and completes production coding when required. A certified coder with 5 years of experience (RHIA/RHIT/CCS/CCS-P/CPC/COC/CIC/CIRCC) is preferred, with at least 1 year as an auditor. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

What We’re Looking For: The Provider Practice Coding Consultant role is an opportunity to make a significant impact in the field of medical coding. You will provide essential consulting services and educational support, guiding healthcare professionals on improved coding practices. Collaborating closely with key stakeholders such as clients and healthcare leaders, you'll meet and exceed customer expectations through identifying and proposing solutions, and being a responsible and reliable teammate. This role offers a unique opportunity to play a pivotal role in elevating coding quality, ensuring compliance, and optimizing service outcomes in both hospitals and alternative care settings. What You Will Do: Review medical records and assign precise codes to ensure accurate coding aligned with client needs (CPT, ICD-10-CM, ICD-10 procedures, ICD-10-CM and ICD-10 PCS, HCPCS). Conduct data quality reviews of records to assess compliance with official coding and documentation...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Job Description Job Description Medical Billing Specialist — Oberlin Road Pediatrics (Raleigh, NC) Why this role? If you're a billing pro who's tired of being just a cog in a massive revenue cycle machine, this is different. You'll own the full billing picture — claims, A/R, denials, patient communication — and see the direct impact of your accuracy on a practice that genuinely depends on you. No weekends, no on-call, and a predictable Monday–Friday, 8–5 schedule that actually lets you have a life outside of work. Why this practice? Oberlin Road Pediatrics isn't a corporate rollup — it's one of North Carolina's oldest and most respected pediatric clinics, built on decades of trust with the families it serves. You'll be joining a genuinely close-knit team where "we're a family" isn't just a tagline on a job posting. Why now? Pediatric and primary care billing experience is in high demand, and this team is ready to invest in someone who wants to grow. If you've got...

Job Responsibilities Strong customer service skills; answering client calls; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally. Prepares charges for offshore operations and answers and resolves questions. Complete chargers and/or resolve charge and payment inquiries for off-shore vendors. Prepares assigns and reconciles batches; provides ongoing communication and reviews discrepancy process. Reviews source codes; tallies Hash totals. Maps ICD nine, CPT, and modifiers as needed. Creates claim edit report for charge entries. Reconciles imputed payment postings and balances batch reports. Prep charges for IHS, indicate any modifiers needed on CPT codes, notate the codes for any handwritten DX, procedure, etc., return any charges to the Doctors office that require clarification. Complete batch once IHS enters by validating, verifying, clarifying/correcting any questions they may have had, and closing...