39 certified coder physician jobs found

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...

Job Title Newport News, Virginia Hiring Range: $23.00 - $29.90/Hourly Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. 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 Ensures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations. What You Will Do Organizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data...

Accurate clinical documentation and coding are essential to ensuring quality patient care, operational excellence, and regulatory compliance. This role offers an experienced outpatient medical coder the opportunity to make a meaningful impact across a broad range of ambulatory specialties while supporting one of the nation's leading academic health systems. As a Coding Quality Specialist 2, you will serve as a trusted coding expert for ambulatory medicine and specialty practices, helping ensure complete, compliant, and accurate code assignment. This position offers the flexibility of remote work , exposure to diverse specialties, and the opportunity to collaborate with providers and clinical teams in a highly respected healthcare environment. The Role As part of a specialized coding team, you will independently review complex outpatient documentation and apply advanced coding knowledge to support coding accuracy, quality initiatives, and regulatory...

Responsibilities One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. Atlantic Region CBO (uhs.com) The Atlantic Region CBO is seeking a dynamic and talented Inpatient...

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...

Hiring Range $23.00 - $29.90/Hourly Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. 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. Newport News, Virginia Overview Ensures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations. What You Will Do Organizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data element. Audits for...

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...

Reid Health is seeking an On-site Coder-Outpatient to professionally code outpatient encounters at the Richmond and Connersville locations. You will perform ICD-10-CM/PCS and CPT-4 coding, abstract clinical data, and calculate APCs to support compliant reimbursement. The role emphasizes up-to-date coding guidelines, timely data entry, and collaboration with providers and coding leadership. A CCS/CPC/RHIT/RHIA certification is required or pursued, and a high school diploma is essential. #J-18808-Ljbffr

Fully Remote Lake Park Building Full time R180277 Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ’s and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately...

## 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,...

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:...

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...

This is a remote based position. Applicants can be located nationwide Back Inpatient Professional Fee, Profee Medical Coder #2848 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Medical Coding . 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? Are you highly committed? Are you team-oriented? Do you value professionalism, trust,...

Job Description Medical Coder - Dumfries, VA Make an Impact. Support Those Who Serve. Spectrum Healthcare Resources is seeking a full-time Medical Coder to join the team at the Dumfries Ambulatory Care Center in Dumfries, VA . This is an opportunity to put your coding expertise to work in a meaningful outpatient healthcare environment supporting active-duty service members, veterans, retirees, and their families. Why You’ll Love This Opportunity Full-time | 40 hours/week Monday-Friday | 7:00 AM-3:30 PM Predictable weekday schedule Outpatient setting No Sundays or on-call responsibilities 11 paid federal holidays Comprehensive benefits: Medical, Dental, Vision & 401(k) Make a difference by supporting the healthcare needs of those who serve our country What You’ll Do As a Medical Coder, you will play an important role in ensuring accurate and compliant medical coding and documentation. Responsibilities include: Review patient charts and documentation for accuracy and...

Location: Fairfax, VA Status: Full-Time / Non-Exempt Salary Range: $23.00 - $29.00 Are you looking for new career opportunities, great wages, excellent benefits, and work-life balance? Follow your heart to Virginia Heart! At Virginia Heart, we are looking for a professional Medical Coder. The Medical Coder is responsible for reviewing, coding and updating charges in various Charge Work Queues, to ensure accuracy and timely release of charges, in a manner consistent with Virginia Heart's mission of excellence in cardiovascular care. When you work with Virginia Heart, you will enjoy a dedicated and experienced staff, competitive wages, excellent benefits and the following rewards and incentives: • No Nights, weekends, or holidays! • Affordable Medical, Dental and Vision plans • 401(k) Retirement Plan • Paid Short-Term Disability • Employee Assistance Program for Mental and Physical well-being • Three Weeks of Paid Vacation upon eligibility • One week of Paid...

General Position Summary: The Medical Coding Specialist works as part of the Billing & Coding Department to review clinical documentation, abstract data from patient medical records, and accurately assign diagnosis and procedure codes in accordance with applicable coding guidelines and regulatory requirements.   Essential Duties and Responsibilities:   1.      Reviews patient medical records and assigns diagnosis and procedure codes in accordance with ICD-10-CM, CPT, HCPCS, and applicable coding guidelines. 2.      Ensure compliance with federal, state, payer, and organizational coding regulations and policies. 3.      Assigns and sequences diagnosis and procedure codes accurately for all services rendered. 4.      Ensures documentation and coding accurately reflect services provided and support quality reporting metrics. 5.      Identifies missed diagnoses, chronic conditions, and documentation deficiencies that may...

## Coder-Outpatient - (On-site)Applylocations: North Complextime type: Full timeposted on: Posted Todayjob requisition id: JR2353Coder-Outpatient - (On-site)7650 Revenue Cycle Management**Schedule:** Day Shift. 40 hours weekly. 7:00 am to 3:30 pm.**About the Position**This position has the responsibility for providing accurate, complete, and appropriate coding using ICD-10-CM/PCS and CPT classification systems for the Richmond and Connersville locations. Assigns appropriate APC grouping according to diagnoses specified in the record by the treating provider(s) and in keeping with regulatory requirements. Abstracts relevant clinical and demographic information from the medical record.**Overview of Responsibilities**• Codes outpatient medical records for the purpose of quality planning and assessment, reimbursement, research and compliance with Federal regulations according to ICD-10-CM and CPT-4 classification systems. • Accurately performs data entry/abstraction on all...

Chesapeake Regional Medical Group is seeking a Senior Coding Specialist to perform coding tasks across physician practices, including obtaining pathology and operative reports, assigning ICD and CPT codes, and ensuring accurate transmissions within the system. The role requires experience in hospital/medical office settings, CPC certification (or within one year), and strong computer skills. You will participate in audits, education, and go-live support across multiple locations. #J-18808-Ljbffr

City / State Norfolk, VA Work Shift First (Days) Overview :Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator / Certified Professional Coder (CPC) Remote! Status :Full-time, permanent position (40 hours) Work hours :8am to 5pm EST, M-F Location :This position is remote for candidates that live in the following states :VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY! With travel to Virginia Beach 1x a year.Job Responsibilities :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...

Reviews claims in assigned work queues in Cerner Revenue Cycle including CMG Review and Ambulatory Edit failure work items.Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges.Determines appropriate action needed to resolve coding edits / issues and ensure clean claim submission.Performs coding functions, including Current Procedure Terminology (CPT), International Classification of Diseases, tenth revision, Clinical Modification (ICD-10-CM), documentation review, and claim denial review.Applies appropriate modifiers.Ensures charges / coding are in alignment with the American Medical Association (AMA),Medicare, and Commercial coding guidelines on all claims reviewed.Credits / updates charges and coding as needed.Ensures queues are worked timely and efficiently.Maintains Productivity and accuracy...

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...

PH Physician Supervisor (Medical Director) Title: PH Physician Supervisor (Medical Director) State Role Title: Physicians and Surgeons, All Other Hiring Range: $203,571.05 - $207,909.99 Pay Band: 8 Agency: Virginia Department of Health Location: Chesterfield HQ Agency Website: https://www.vdh.virginia.gov/chesterfield/ Recruitment Type: General Public - G Job Duties The Virginia Department of Health (VDH) is dedicated to protecting and promoting the health of Virginians. The VDH is made up of a statewide Central Office in Richmond and 33 local health districts. The Chesterfield Health District provides public health services to the residents of Chesterfield County, Powhatan County, and the City of Colonial Heights. This position is based in the Chesterfield Health Department. Are you interested in providing clinical care while working on ways to address the upstream causes of preventable diseases? The Chesterfield Health District is looking for a physician-leader who has...

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...

Inpatient Coder II Newport News, Virginia Hiring Range: $27.30 - $37.58/Hourly. Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. 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: The Inpatient Coder II is responsible for analyzing the medical record to assign International Classification of Diseases (ICD) Clinical Modification (CM) diagnoses and Procedure Coding System (PCS) procedure codes to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines. Works in collaboration with the Clinical Documentation Improvement (CDI) team to ensure accurate Diagnosis Related Group (DRG) assignment and works closely with management to resolve problems and meet deadlines. What You Will Do: Assigns International Classification of Diseases...