23 certified coder analyst jobs found

Job Description Job Description Description: About the Company: NextStep Technology Inc. is seeking a Medical Records Analyst. The medical records analyst is primarily responsible for review of health information. The MRA reviews the medical records for specific criteria and validation of specific code year sets submitted from selected organizations to government and commercial client. The position requires review of protected health information and must maintain strict confidentiality when addressing or referring to such records. The incumbent must have the ability to use a variety of office equipment, computer software, the ability to use sound and professional judgement, and to work independently. The candidate(s) will be hired as an employee up to 40 hours per week (flexible scheduling). This is a remote position About the Role: The medical records analyst is primarily responsible for review of health information. Responsibilities: Analyze protected...

Become a part of our caring community Become a part of our caring community and help us put health first. Role Overview The 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, you will be assigned 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,...

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...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Join Our Caring Community Become a part of our caring community and help us put health first. The 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...

***To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia*** The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

Become a part of our caring community and help us put health first. The 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. The role is 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, research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, you will be assigned 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...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

Posting Details Posting Summary Working Title Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Role Title Role Code FLSA Exempt Pay Band UG Position Number 295A0003 Agency Tidewater Community College Division Tidewater Community College (Div) Work Location Suffolk - 800 Hiring Range $30-$100 per hour, commensurate with qualifications and experience. Emergency/Essential Personnel No EEO Category I-Faculty Full Time or Part Time Part Time Does this position have telework options? -Telework options are subject to change based on business needs- No Does this position have a bilingual or multilingual skill requirement or preference? Work Schedule Varies Sensitive Position No Job Description Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Tidewater Community College has served South Hampton Roads – both students and employers – for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of whom pursued degrees that would let them transfer to 4-year institutions. Of South Hampton Roads residents enrolled in higher education 33% enrolled at TCC. TCC's institutional accreditation is affirmed through 2027 by the Southern Association of Colleges and...

Title: Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Agency: Tidewater Community College Location: Suffolk - 800 FLSA: Exempt Hiring Range: $30-$100 per hour, commensurate with qualifications and experience. Full Time or Part Time: Part Time Additional Detail Job Description: Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of...

Accountant 1 – Medical Billing Specialist Salem, OR – Equitable Center. Salary: $4,519.00 – $6,904.00. Put your medical billing expertise to work for Oregon’s youth. The Oregon Youth Authority (OYA) is hiring an Accountant 1 – Medical Billing Specialist to manage Medicaid billing and reimbursement that directly funds treatment and services for youth in our care. The hybrid role handles Medicaid Management Information System billing, Title XIX eligibility reviews, and remittance reconciliations, ensuring accurate, compliant, timely claims. Responsibilities Review and verify medical billing codes and reimbursement rates for payments to providers. Track and maintain records supporting reimbursement claims, ensuring accuracy, completeness, and compliance with audit requirements. Analyze remittance advice from the Oregon Health Authority to verify accuracy, identify discrepancies, and ensure compliance with Medicaid billing and reimbursement requirements. Minimum Qualifications...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

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 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...

Position: Medical Billing Specialist Location: Remote / On-site Department: Revenue Cycle Management Overview CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that enhance medical billing workflows. The ideal candidate will have expertise in medical coding, claims submission, payer interactions, and denial management, ensuring optimized billing practices for maximum reimbursement and minimal claim rejections. Why Join CMCI? Opportunity to work with cutting-edge AI-driven billing solutions that optimize RCM efficiency. Work in a collaborative environment with healthcare and AI professionals. Competitive salary, benefits, and professional development opportunities. Key Responsibilities Claims Processing & Submission: Accurately process, review, and submit medical claims. Verify CPT, ICD-10, and HCPCS codes to ensure claims...

Job Summary The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Reports to the Manager, Medicare Risk Adjustment. Responsibilities Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports. Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provide on‑site education, based on business needs. Collaborate with other market provider‑facing roles. Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data‑driven educational materials and interventions. Participate in cross‑functional teams to improve documentation, data integrity, and...

## 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,...

Humana is seeking a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and to create education plans tailored to each assigned provider. This role reports to the Manager, Medicare Risk Adjustment. The candidate will arrange sessions, analyze coding quality with data visualization, and deliver on-site education while collaborating with market provider-facing teams. Up to 5% travel may be required. #J-18808-Ljbffr

Job Title Risk Coder Location Virginia Beach, VA Work Shift First (Days) Job Description 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, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs...

Humana is seeking a Medical Coder / Coding Educator 2 to identify opportunities to improve provider documentation and create customized education plans. The role reports to the Manager, Medicare Risk Adjustment. You will arrange educational sessions, analyze coding quality trends, and deliver on-site education while collaborating with market provider-facing teams. Strong data skills and Risk Adjustment knowledge are essential. #J-18808-Ljbffr

Job Description Job Description About Us: Dominion Women’s Health is dedicated to delivering high-quality healthcare services with accuracy, efficiency, and integrity. We are seeking a detail-oriented and knowledgeable Medical Coder to join our team on-site and play a critical role in ensuring proper coding and billing practices. As a part of our team, all employees must maintain strict confidentiality and adhere to all HIPAA and OSHA regulations to ensure patient privacy and workplace safety. Qualifications: Certified Professional Coder or Certified Professional Coder Apprentice 1–2 years of coding experience preferred (newly certified candidates may be considered). Strong knowledge of ICD-10, CPT, and HCPCS coding guidelines. Ability to work independently with strong attention to detail. Excellent communication and organizational skills. Must be willing to submit to a background investigation, including for example, verification of your past employment, criminal...