47 clinical data coder jobs found

The Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and educations associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider (MD/DO, APP, and other non-physician practitioners) organizations remains in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance. MINIMUM QUALIFICATIONS EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR ; Associate’s Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding. Current certification in one of the following: Certified Professional Coder (CPC)through the American Academy of Professional Coders (AAPC) Registered Health...

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses. Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements. Review and verify accuracy of billing data within...

The Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and educations associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider (MD/DO, APP, and other non-physician practitioners) organizations remains in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance. MINIMUM QUALIFICATIONS EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR ; Associate’s Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding. Current certification in one of the following: Certified Professional Coder (CPC)through the American Academy of Professional Coders (AAPC) Registered Health...

Remote Same Day Surgery Coder Location: Remote ( must reside in either Virginia, North Carolina, Florida, Texas) Schedule: Full-Time, Monday-Friday (40 hours/week) Start Time: Flexible, typically between 5:00 AM and 8:00 AM About the Opportunity We are seeking an experienced Outpatient Surgery Coder to join a collaborative hospital coding team. In this role, you will be responsible for accurately reviewing clinical documentation and assigning ICD-10, CPT, and HCPCS codes for outpatient surgery, observation, and ancillary encounters. This position offers the opportunity to work in a supportive environment with strong leadership, ongoing quality review processes, and a balanced workload distributed through Epic work queues. Key Responsibilities Code ambulatory surgery, observation, and ancillary encounters. Review operative reports and clinical documentation to assign accurate ICD-10, CPT, and HCPCS codes. Abstract clinical and demographic data into...

Job Title Match Insights Job Requirements Naval Medical Center Portsmouth, VA Top Secret/SCI Polygraph Unspecified Career Level not specified Salary not specified Join Premium to unlock estimated salaries Job Description Duties Analyze patient medical records to identify inaccurately coded services in accordance with federal coding regulations and guidelines. Assign specific codes to medical records, sequencing and determining codes to accurately reflect the resources and procedures used in the care of the patients. Ensure compliance with regulatory and third-party insurance requirements in utilizing the ICD-10-CM, and CPT coding books. Perform limited utilization review of outpatient and inpatient records to assure the diagnosis responsible for the length of stay is appropriately identified. Assure secondary diagnoses are sequenced properly to assure maximum allocation under the Relative Value Unit (RVU) and Diagnosis-Related Group (DRG) systems. Provide...

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...

Medical Coder 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 35 years of medical coding experience Knowledge of MedDRA and WHO Drug coding systems Preferred Qualifications: Medical coding certification Experience supporting clinical trials

Pay or shift range: $23.02 USD to $35.22 USD The pay range reflects the current compensation range for this position at the time of posting. Individual offers are determined based on directly related experience, skills, education, internal equity, and other job-related factors. Not all candidates will qualify for the upper end of the posted range. Description 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...

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 balance....

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...

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

## 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...

## 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,...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

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 vendor...

Job Description Job Description Description:   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. Requirements:   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 

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses. Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements. Review and verify accuracy of billing data within...

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...

Job Title Medical Records Analyst Duties Analyze patient medical records to identify inaccurately coded services in accordance with federal coding regulations and guidelines. Assign specific codes to medical records, sequencing and determining codes to accurately reflect the resources and procedures used in the care of the patients. Ensure compliance with regulatory and third-party insurance requirements in utilizing the ICD-10-CM, and CPT coding books. Perform limited utilization review of outpatient and inpatient records to assure the diagnosis responsible for the length of stay is appropriately identified. Assure secondary diagnoses are sequenced properly to assure maximum allocation under the Relative Value Unit (RVU) and Diagnosis-Related Group (DRG) systems. Provide review and analysis of coding accuracy and compliance statistics, coordinating results with the Coding Manager and Patient Administration Department Head for feedback to the providers. Prepare...

Venesco, LLC is seeking a detail-oriented Medical Coder to support clinical trials from a remote/hybrid location. The role involves coding medical terminology using MedDRA and WHO Drug dictionaries, ensuring the quality of coded clinical data, and reviewing case report forms for accuracy. Candidates should have a Bachelor’s degree in life sciences and 3–5 years of experience in medical coding. Preferred qualifications include medical coding certification and experience with clinical trials. #J-18808-Ljbffr

Fully Remote Lake Park Building Full time R180631 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...

This is a remote based position. Applicants can be located nationwide Back Observation Medical Coder #2895 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, honesty, and...

JOB SUMMARY : The Medical Coding Specialist is responsible for providing billing analysis of claims and applying coding standards and federal regulations to ensure correct billing practices. In this role, you will perform bill and chart reviews to identify any variation from quality billing practices and monitor patient bills for accuracy and compliance. This position also requires awareness of international coding systems and healthcare billing practices to support global operations and ensure alignment with international regulatory standards. JOB ROLES AND RESPONSIBILITIES: Review and analyze inpatient, outpatient, and provider billing for medical appropriateness of treatment; analyze charges across various revenue centers with consideration to patient diagnosis, procedures, age, facility type, and international healthcare norms where applicable. Apply recommendation of national coding and international coding and regulation standards (e.g., ICD-10-AM, OPCS-4,...

Job TitleNewport News, Virginia$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.OverviewEnsures 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 DoOrganizes 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 documentation...