136 certified professional coder jobs found

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. Position Summary The Certified Professional Coder (CPC) will perform medical claim reviews 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. Activities include: Conduct a...

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...

This position may be filled prior to the posted deadline. Koniag Advisory Business Solutions, LLC a Koniag Government Services company, is seeking a Medical Records Technician Coder III to support KABS and our government customer. The position is remote. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. Benefits include medical, dental, and vision insurance, 401(k) retirement plan, paid time off, paid parental leave, life and disability insurance, flexible spending accounts, commuter benefits and tuition reimbursement. Koniag Advisory Business Solutions (KABS) is seeking an experienced Medical Records Technician – Coder III to support the Indian Health Service (IHS) Haskell Indian Health Center. This is a fully remote position responsible for accurate and timely coding of outpatient and ambulatory patient encounters and supporting the facility's efforts to reduce its existing coding backlog and...

Valley Health System in Blacksburg seeks a seasoned clinical documentation auditor to conduct reviews of billed services for VMG enterprise accuracy. This role supports audit responses and improves coding quality across departments. The candidate will assist in payor and governmental audits, respond to denials and inquiries, and research new coding guidelines to enhance reimbursement processes and corporate compliance. #J-18808-Ljbffr

POSITION SUMMARY Conducts reviews and provides recommended corrections of billed services as it relates to clinical documentation for the VMG enterprise. Assists in the reviews and responses to payor and governmental audits of billed services. Assists the CBO in replying to payor denials and patient inquiries as it relates to services billed. Reviews and research new coding guidelines and codes. Assists the staff of the VHS corporate compliance. EDUCATION CPC (AAPC) required. Degree in Heath Services Management, Business or another related field preferred. Extensive knowledge of ICD-9-CM/ICD-10 CM and CPT coding principles and guidelines required. Extensive knowledge of reimbursement systems required. EXPERIENCE Eight to ten years’ experience (college degree can be substituted for years of experience) and expertise in ICD-9 CM/ICD-10 CM Coding. SPECIAL SKILLS Medical Terminology, ICD-9 CM/ICD-10 CM and CPT-4 Coding, Ability to relate to people and work closely with physicians and...

Job Title Help Job Description Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and official coding guidelines.

Tidewater Physicians Multispecialty Group P C in Newport News, VA is seeking a Coder I to perform post-claim reviews, identify coding issues, and support accurate reimbursement. The role requires knowledge of CPT, HCPCS, ICD-10-CM, strong attention to detail, and teamwork with billing and clinical staff to educate and optimize documentation. Active CPC certifications and up to 2 years of coding experience preferred. #J-18808-Ljbffr

Coding Educator/AuditorInsight Global is seeking a Coding Educator/Auditor for a healthcare system in Virginia. The educator will provide consulting services to physicians, residents, allied health professionals and billing staff to support patient care documentation, coding and billing practices according to federal, state and local regulatory compliance standards.• Creates and delivers presentations to clinical faculty and billing staff.• Develops training programs and delivers training and education sessions for physicians, allied health professionals, residents, and coding and billing staff to support compliance with third party documentation and billing regulatory standards, including but not limited to classroom training, web-based training and one-on-one provider observation and training sessions.• Participates on clinical department Billing Quality Councils as a member of the respective councils and acts as the primary resource providing technical and regulatory expertise...

Pathology Coder IIIRequired Skills & Experience Must Haves:5+ years of medical coding experienceCoder III level experiencePathology coding experienceExperience processing both PB and HB chargesEpic experience requiredStrong knowledge of CPT, ICD-10, HCPCS, and pathology coding guidelinesExperience coding anatomic pathology specimensCoding experience would include surgical specimens such as Bone Marrows, hysterectomies, organ resectionsJob Description:The Pathology Coder III is responsible for reviewing pathology documentation and assigning accurate ICD-10, CPT, and HCPCS codes for pathology and laboratory services. This individual will support both professional and hospital billing functions by ensuring coding accuracy, compliance, and appropriate charge capture. The ideal candidate has extensive pathology coding experience and a strong understanding of coding regulations, reimbursement methodologies, and documentation requirements.Note: UVA Health is seeking an experienced...

Job Title Help Job Description Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and official coding guidelines.

Sentara Medical Group in Virginia Beach, VA is hiring a full-time hybrid Risk Adjustment Coder. The role involves in-office presence 1–2 days per week with remote work options, and occasional travel to support collaboration and business objectives. Responsibilities include risk adjustment coding per CMS/HHS guidelines, RADV audits, and reviews of professional and inpatient/outpatient services to ensure accurate HCC capture. Certification in CRC within two years is required. #J-18808-Ljbffr

Amazon One Medical Senior Health Revenue Cycle team seeks a Medical Coder I to support Clinical and Revenue Cycle teams by reviewing coding accuracy of claims. This role reports to the Manager I, Finance. The candidate will maintain CPT/ICD-10-CM expertise, assign codes for visits and procedures, and collaborate with the Medicare Risk Operations team to drive program outcomes while meeting One Medical standards. #J-18808-Ljbffr

Job Description Job Description Description:   Charge Capture and Claim Submission Review and verify charges, CPT/ICD-10/HCPCS codes, and modifiers for orthopedic office visits, procedures, injections, imaging, DME, and surgical services before billing. Prepare, scrub, and submit clean claims to commercial, government, and third-party payers through athenaOne, resolving claim edits and clearinghouse rejections promptly. Track global surgical periods, bundling rules, and payer-specific requirements to ensure correct billing for orthopedic procedures. Denial Management and Appeals Work denials, rejections, kicked claims, and no-response claims daily in athenaOne; determine the kick reason and root cause, correct, and resubmit within payer timely-filing limits. Draft and submit appeals with supporting documentation, including for medical-necessity, authorization, coordination-of-benefits, and downcoding denials common in orthopedics. Route registration-driven denials...

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 required...

Centra Health in Lynchburg seeks an Hospital Inpatient Coding Specialist to assign ICD-10-CM diagnosis and ICD-10-PCS procedure codes for APR-DRG or MS-DRG reimbursement. The role emphasizes accuracy and adherence to Centra’s coding policies and guidelines. You will collaborate with the Clinical Documentation Integrity Specialist to abstract relevant information, ensuring data integrity and proper documentation while formulating provider queries when needed. #J-18808-Ljbffr

A Coder I performs post claim reviews of denied and retracted claims to identify coding-related issues, determine appropriate corrections, and provide feedback to providers, office staff, billing staff, and other departments. This position supports accurate coding and appropriate reimbursement by reviewing medical record documentation, researching coding guidelines, identifying trends in coding-related denials, and providing education and recommendations to improve coding accuracy and documentation. The Coder I works collaboratively with the Billing team, site staff, providers, and other departments to resolve coding-related issues and support successful claim resolution.Major Duties and ResponsibilitiesMaintains working knowledge of current CPT, HCPCS, ICD-10-CM, medical terminology, and applicable coding guidelines and payer requirements.Reviews denied and retracted claims to identify coding, documentation, modifier, diagnosis, or other claim-related issues contributing to the...

DaMar Staffing invites applications for a Pathology Coder III to review pathology documentation and assign ICD-10, CPT, and HCPCS codes for pathology and lab services. You will support both professional and hospital billing with rigorous accuracy and compliance. The role emphasizes handling complex anatomic pathology specimens, ensuring proper charge capture, and meeting regulatory requirements while transitioning clinics to Epic workflows. #J-18808-Ljbffr

GI Coder III Required Skills & Experience Must Haves: 5+ years of professional medical coding experience Coder III level experience Extensive GI coding experience Experience coding: Colonoscopies EGDs (Esophagogastroduodenoscopy procedures) Other GI surgical procedures Experience in: Endoscopy Suites Ambulatory Surgery Centers (ASCs) EPIC experience required Experience with coding encoders such as: Codify Encoder Pro Experience using ProVation Nice to Have Skills & Experience Nice to Haves: Academic medical center experience Experience supporting system conversions or EMR transitions Job Description The GI Coder III is responsible for reviewing and assigning accurate ICD-10, CPT, and HCPCS codes for a variety of gastroenterology procedures and services. This individual will analyze physician documentation, operative reports, endoscopy reports, and related medical records to ensure coding accuracy, compliance, and appropriate reimbursement. The ideal...

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 Inpatient Coder for our Appeals department. The primary responsibility of the DRG Coder is to analyze third party coding audits of paid claims, draft detailed appeal letters, evaluate clinical level of care and review denial trends. Key Responsibilities include: Perform DRG (Diagnosis Related Group) validation reviews in response to audits from third party payers. Review audit findings letters from third party payers to obtain a clear understanding of audited diagnosis codes and underlying payer clinical / coding rationale. Analyze medical records to obtain supporting clinical documentation...

Become a part of our caring community Become a part of our caring community and help us put health first *** $5,000 SIGN-ON BONUS for new associates! $5,000 payable following 90 days employment. *** 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...

Medical Records Technician Coder IIIKoniag Advisory Business Solutions, LLC a Koniag Government Services company, is seeking a Medical Records Technician Coder III to support KABS and our government customer. The position is remote. This position requires the candidate to be able to obtain a Public Trust.This position is covered under the Service Contract Act. Benefits include medical, dental, and vision insurance, 401(k) retirement plan, paid time off, paid parental leave, life and disability insurance, flexible spending accounts, commuter benefits, and tuition reimbursement.Koniag Advisory Business Solutions (KABS) is seeking an experienced Medical Records Technician – Coder III to support the Indian Health Service (IHS) Haskell Indian Health Center. This is a fully remote position responsible for accurate and timely coding of outpatient and ambulatory patient encounters and supporting the facility's efforts to reduce its existing coding backlog and maintain coding currency.The...

Medical Coder Location: Remote/Hybrid Job Type: Full-Time Position Overview Venesco is seeking a detail-oriented Medical Coder to support clinical trials through accurate coding and reconciliation of medical data. Key Responsibilities Code medical terminology using MedDRA and WHO Drug dictionaries Ensure consistency and quality of coded clinical trial data Review case report forms (CRFs) for accuracy Maintain coding conventions and documentation Generate coding reports and support data reconciliation activities Minimum Qualifications Bachelor’s degree in life sciences or related field 3–5 years of medical coding experience Knowledge of MedDRA and WHO Drug coding systems Preferred Qualifications Medical coding certification Experience supporting clinical trials #J-18808-Ljbffr

Augusta Health, located in Fishersville, Virginia, seeks a Coder II to ensure accurate ICD-10-CM, HCPCS coding and timely billing support within the HIM team. This role emphasizes high-quality coding, regulatory compliance, and collaboration with Business Office to optimize revenue cycle metrics. The position requires CCS or CPC certification and relevant experience; offers comprehensive benefits, competitive pay, and on-site opportunities in a supportive health system. #J-18808-Ljbffr

78 Medical Center Drive, Fishersville, VA 22939, USA At Augusta Health, your work matters — and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer more than just a job — we offer a purpose-driven career in a nationally recognized, independent health system located in Virginia’s scenic Shenandoah Valley. Our team members thrive in a supportive culture that values collaboration, integrity, and excellence. With opportunities across clinical and non-clinical areas, Augusta Health is a place where your skills make a difference, and your growth is a priority. Why Join Augusta Health? We believe in taking care of the people who care for our community. That’s why Augusta Health offers a comprehensive and thoughtfully designed benefits package that supports your well‑being, career development, and work‑life...