39 certified coder cpc css jobs found

A leading health system in Virginia is seeking a HIM Certified Coder to review medical records and assign Diagnosis and Procedure codes in accordance with coding guidelines. The ideal candidate will have a high school diploma, CCS certification, and at least 2 years of experience in a hospital setting. Candidates with a CPC credential are also encouraged to apply, but must pass the CCS exam within one year. This position supports critical medical advances and patient care. #J-18808-Ljbffr

Job Title: Medical Biller (Medicaid & MCO - Behavioral Health) Full-time Office Address: 20116 Ashbrook Pl #100 Ashburn, VA Compensation: USD 25 - USD 28 - hourly Position Summary The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims for services billed to DC Medicaid and Managed Care Organizations (MCOs). This role ensures compliance with District of Columbia Department of Health Care Finance (DHCF) regulations and payer‑specific billing requirements while supporting revenue cycle efficiency. Eligibility & Authorization Verification Verify Medicaid eligibility using systems such as DC Access System or other payer portals. Confirm MCO enrollment and service coverage prior to claim submission. Track and manage prior authorizations and limitations. Claims Submission & Processing Submit clean claims to DC Medicaid and MCOs (e.g., AmeriHealth Caritas DC, MedStar Family Choice DC, Wellpoint, HSCSN)....

Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are...

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. 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, allowing you to help shape the...

Certified Coder The Atlantic Region Central Billing Office (CBO) is seeking a dynamic and talented Certified Coder. The primary responsibility of the Coder is to assist the CBO with the review of medical records, assign ICD-10 and CPT codes to Inpatient or Outpatient records as needed, meet productivity requirements and meet all legal (federal and state) coding requirements. Key responsibilities include: Analyze and evaluate medical records and assign appropriate ICD-10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Reviews APC edits and add modifiers or delete charges as needed Consult with hospital staff when necessary to secure sufficient information to clarify data for proper coding and resolve discrepancies in the documentation and information contained in the medical record Works all daily facility reports as assigned to assure accurate and timely billing of accounts. Assist all CBO staff in relation to coding issues and/or questions that...

Certified Coder The Atlantic Region Central Billing Office (CBO) is seeking a dynamic and talented Certified Coder. The primary responsibility of the Coder is to assist the CBO with the review of medical records, assign ICD-10 and CPT codes to Inpatient or Outpatient records as needed, meet productivity requirements and meet all legal (federal and state) coding requirements. Key responsibilities include: Analyze and evaluate medical records and assign appropriate ICD-10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Reviews APC edits and add modifiers or delete charges as needed Consult with hospital staff when necessary to secure sufficient information to clarify data for proper coding and resolve discrepancies in the documentation and information contained in the medical record Works all daily facility reports as assigned to assure accurate and timely billing of accounts. Assist all CBO staff in relation to coding issues and/or questions that...

Inpatient Coder (Remote) Full-time Work From Home Must have CCS, RHIA, or RHIT certification Job Summary As a Coding Integrity Specialist III WORK FROM HOME, you will review and evaluate hospital inpatient medical record documentation to assign, sequence, edit and/or validate the appropriate ICD-10-CM and ICD-10-PCS codes. A CIS III performs coding and/or code/DRG validation across multiple entities by applying all appropriate coding guidelines and criteria for code selections. Job Qualifications Assign, sequence, validate, and/or edit codes/DRGs and abstracted data (e.g., physician, discharge disposition, query tracking) for inpatient records for multiple facilities using ICD-10-CM and ICD-10-PCS Maintain or exceed established accuracy standards Maintain or exceed established productivity standards Utilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGs Undergraduate (Associate's or Bachelor's)...

Coding Specialist Newport News, Virginia This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Overview Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. What you will do Ensures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement policies. Identifies training needs and provides education to team members. May teach or coordinate coding huddles. Coaches and mentors staff. Performs focused reviews and quality...

Medical Coding Specialist The purpose of this position is to review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges; Retrieves information from medical records, ensuring adherence with established methods and procedures. Key Responsibilities/Accountabilities: Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-9-CM and CPT-4 coding conventions. Sequence the diagnoses and procedures using coding guidelines. Ensure DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Serves as backup to other administrative functions as assigned. Meets job standards for achieving contract deliverables. Assists with other job- and education-related duties as assigned. Other duties as assigned Read, understand, and adhere to all...

Monday through Friday 8:00 AM to 4:30 PM GENERAL SUMMARY Under general supervision, the Hospital Medical Coder II is responsible for the collection of relevant, pertinent, accurate and timely profile data configured and/or abstracted from the hospital's outpatient, observation, day surgery, urgent care and emergency records moving from the least complex to the most complex. This position maybe responsible for coding inpatient records as needed/requested by management; this includes effective use of relevant coding systems as well as recognizing what data can be abstracted, presented and interpreted for effective use throughout the hospital network. Reports to department management. ESSENTIAL DUTIES AND RESPONSIBILITIES Uses established coding guidelines to ensure the most effective and accurate coded profile on the patient. Abstracts pertinent and accurate data from the clinical record. Works with hospital and clinical staff to ensure that accurate and...

Inova Health is looking for a dedicated Medical Records Coder Supervisor to join the Inpatient team. Full-time Day Shift: Monday-Friday, general office hours, working remotely. This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance: offeringup to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: offering all Inova team members, their...

Inova Systems Operations is looking for a dedicated Medical Records Coder 4 for Inpatient. This role will be full-time day shift with a negotiable schedule. This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance: offeringup to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: offering all Inova team members, their spouses/partners, and...

Company Overview Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Medical Coder-Inpatient to join our growing team. Job Summary: The Medical Coder is responsible for reviewing inpatient medical record documentation to ensure the accuracy, completeness, and...

***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)...

Responsibilities Atlantic Region CBO: The Atlantic Region Central Billing Office ("ARCBO") or ("CBO") provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals. https://jobs.uhs.com/atlantic-region-cbo The Atlantic Region CBO is seeking a dynamic and talented Certified Coder. The primary responsibility of the Coder is to assist the CBO with the review of medical records, assign ICD-10 and CPT codes to Inpatient or Outpatient records as needed, meet productivity requirements and meet all legal (federal and state) coding requirements. Key Responsibilities include: Analyze and evaluate medical records and assign appropriate ICD-10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Reviews APC edits and add modifiers or delete charges as needed Consult with hospital staff when necessary to secure...

Medical Coding Specialist II Location: Virginia Beach, VA Work Shift: First (Days) Overview: The 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. Education High School Diploma or Equivalent (Required) Certification/Licensure...

Position: Medical Coding Specialist (Outpatient) Location: Falls Church, VA (Hybrid-3 days onsite) Duration: Long Term(03/24/2026 - 09/23/2026 with 960 hours in total and with further extensions) Job Description: • We are seeking a certified and experienced Medical Coding Specialist (Outpatient) to support Client- Patient Administration Division (PAD) initiatives. The ideal candidate will have strong expertise in outpatient coding, auditing, and compliance within Military Health System (MHS) and MHS GENESIS environments, ensuring accurate and timely coding aligned with DoD standards. Responsibilities: • Perform accurate Outpatient Medical Coding using ICD-10-CM, CPT, and HCPCS in compliance with Client and DoD guidelines • Conduct Coding Audits and Quality Reviews to ensure accuracy, completeness, and regulatory compliance • Review and analyze clinical documentation to assign appropriate diagnosis and procedure codes • Work within MHS (Military Health Systems) and...

Job Description Inova Health is looking for a dedicated Medical Records Coder Supervisor to join the Inpatient team. Full-time Day Shift: Monday-Friday, general office hours, working remotely. This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance: offeringup to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: offering all Inova team...

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...

Universal Health Services is seeking a Certified Coder for the Atlantic Region Central Billing Office in Richmond, VA. The primary role includes reviewing medical records and assigning ICD-10 and CPT codes, ensuring compliance with legal standards. The ideal candidate will have a High School Diploma or equivalent and coding credentials (CPC or CCS). Benefits include competitive compensation, health plans, and opportunities for career development within UHS and its subsidiaries. #J-18808-Ljbffr

Responsibilities Atlantic Region Central Billing Office (ARCBO) provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to affiliated Universal Health Services hospitals. The Atlantic Region CBO seeks a dynamic and talented Certified Coder . The primary responsibility of the coder is to assist the CBO with the review of medical records, assign ICD-10 and CPT codes to inpatient or outpatient records as needed, meet productivity requirements, and meet all legal (federal and state) coding requirements. Key Responsibilities Analyze and evaluate medical records and assign appropriate ICD-10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Review APC edits and add modifiers or delete charges as needed. Consult with hospital staff when necessary to secure sufficient information to clarify data for proper coding and resolve discrepancies in the documentation and information...

Universal Health Services, Inc. is seeking a Certified Coder in Richmond, Virginia. The role involves analyzing medical records and assigning ICD-10 and CPT codes, ensuring compliance with coding guidelines. Candidates must have a High School Diploma and relevant coding credentials (CPC or CCS). Strong Microsoft Office skills and attention to detail are essential. The position offers competitive compensation, excellent medical benefits, and career development opportunities within UHS across its 300+ subsidiaries. #J-18808-Ljbffr

Hospital Inpatient Coding Specialist The Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR-DRG) or Medical Severity Diagnosis Related Group (MS-DRG) for optimal reimbursement. The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra's coding policies. The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information. Responsibilities Assigns diagnosis and procedure codes. Verifies accuracy of DRG Accurately abstracts...

Atlantic Region CBO The Atlantic Region Central Billing Office ("ARCBO") or ("CBO") provides business office services including billing, collections, cash posting, pre‑access management, variance, and customer service to our affiliated Universal Health Services hospitals. Responsibilities The Atlantic Region CBO is seeking a Certified Coder . The primary responsibility of the Coder is to assist the CBO with the review of medical records, assign ICD‑10 and CPT codes to inpatient or outpatient records as needed, meet productivity requirements and meet all legal (federal and state) coding requirements. Key Responsibilities Analyze and evaluate medical records and assign appropriate ICD‑10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Review APC edits and add modifiers or delete charges as needed. Consult with hospital staff when necessary to secure sufficient information to clarify data for proper coding and resolve discrepancies in the...