97 coder jobs found

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...

Outpatient Specialty Medical Coder The Outpatient Specialty Medical Coder is responsible for coding outpatient records, Facility, and/or Professional, for the purpose of reimbursement in compliance with federal, state, and regulatory agencies' guidelines using the most current taxonomic and classification systems. Performs coding, charge entry, and charge review including but not limited to, reviewing clinical documentation, appending modifiers and/or correcting edits. The Outpatient Specialty Medical Coder I will be responsible for coding the following services: Non Centra Medical Group (CMG) Vascular, Endoscopy, Orthopedic Surgery, Gynocologic Surgery, Surgical Observation, General Surgery, Plastic Surgery, Neurosurgery, Urology, Bariatric Surgery, and Pain Management. Responsibilities Reviews clinical documentation and assigns appropriate outpatient facility and/or professional codes, reviews/posts charges for the purpose of reimbursement, research, and compliance in...

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...

City / StateNorfolk, VAWork ShiftFirst (Days)Overview :Claims Resolution Coder- RemoteResponsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE),or other third party payer specific claims processing guidelines.Works with Coding, Billing and Reimbursement staff to resolve edits.Is additionally responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing.Researches regulations to ensure accuracy of CPT codes and documentation.Associates degree in Health Information Technology or Medical Billing preferred.2 years direct application of coding, medical billing or reimbursement in health care setting, hospital or physician office required.CPC or CCS coding certification required at time of hire.Thorough knowledge of lab,...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Job Title Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

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 Coder. The...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

Join Datavant, the leader in health data exchange, and contribute to a mission where every healthcare decision is driven by accurate data. Our extensive platform connects the healthcare ecosystem, providing secure and accessible data that enhances health decisions. We are proud to work with top life sciences companies, government entities, and healthcare providers. As a part of our high-performing, values-focused team, you will help tackle complex healthcare challenges with innovative, technology-driven solutions. At Datavant, we value diverse experiences and backgrounds, and we’re seeking experienced and credentialed outpatient coders like you! This fully remote position offers a flexible schedule, allowing you to make a difference in healthcare from the comfort of your own home. Role Overview: Review medical records to accurately code diagnoses and procedures. Sequence codes based on medical record documentation. Assign appropriate discharge dispositions. Abstract...

Join Datavant, a leading data platform company revolutionizing health data exchange! We are dedicated to ensuring every healthcare decision is supported by the right data at the right time. Our extensive health data network provides secure, accessible, and usable data, enabling healthcare professionals to make informed decisions. By becoming a part of our high-performing team, you will tackle some of healthcare's most complex challenges with innovative technology solutions. We value diversity in professional, educational, and personal experiences to achieve our ambitious vision. We are seeking experienced and credentialed outpatient coders to enhance our team. Candidates should have exceptional attention to detail and a robust understanding of medical terminology. This fully remote role offers a flexible schedule, allowing you to contribute to the future of healthcare from your own workspace! Key Responsibilities: Review medical records and accurately assign codes for...

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 Supervisor to join our growing team. Job Summary: Acentra Health is seeking an experienced Medical Coding Supervisor to lead and oversee medical coding operations in support of...

Certified Medical Coder Specialist Our Business Department is currently welcoming a temporary full-time Certified Medical Coder Specialist! This position is fully in-person and not remote. Key responsibilities include assembling and analyzing all discharged records and maintaining an organized system for notification of deficiencies. Responsible for sending reports to referral sources and healthcare providers as identified. Assigns appropriate medical codes to charts to assure accurate billing. Assists with data collection and presentation for facility PI activities. Responsible for release of medical record information from active and discharge files in accordance with all applicable legal, accrediting, and regulatory agency requirements. Files all loose reports into discharged records. Maintains "copy" file and outside information file. Maintains permanent file and incomplete chart file. Coordinates the transcription of dictated or written materials for medical record reports....

Medical Records Coder 3 Inova Health is looking for a dedicated Medical Records Coder 3 to join the HB Coding Operations team. This role is Full-time working daytime hours Monday to Friday | REMOTE. 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: offering up 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...

Medical Record Reviewer Position Status Label: Non-Exempt Labor Category: Admin Remote/Onsite: Remote Additional Informations: This job is for new sourcing 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 ...

Job Description Schedule: Full Time Weekdays Only. Hybrid Remote/Onsite Location: This position is primarily remote. Incumbents will need to attend occasional onsite staff and provider meetings/trainings. Must live within reasonable commuting distance from Warrenton, Virginia. Your experience matters Fauquier Health is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Medical Coder on the Physician Services team, you're embracing a vital mission dedicated to making communities healthier ®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve. More about our team Fauquier Health Physician Services is made up of board-certified providers offering a wide range of specialties to meet the diverse needs...

Responsibilities Our Business Department is currently welcoming a full time Certified Medical Coder Specialist! **This position is fully in-person and not remote** Key Responsibilities: Assemble and analyzes all discharged records and maintains an organized system for notification of deficiencies. Responsible for sending reports to referral sources and healthcare providers as identified. Assigns appropriate medical codes to charts to assure accurate billing. Assists with data collection and presentation for facility PI activities. Responsible for release of medical record information from active and discharge files in accordance with all applicable legal, accrediting and regulatory agency requirements. Files all loose reports into discharged records. Maintains "copy" file and outside information file. Maintains permanent file and incomplete chart file. Coordinates the transcription of dictated or written materials for medical record reports. The Medical Coder...

Using advanced knowledge required for the complex analytical functions of this job, the Analyst conducts compliance and privacy investigations using expertise of investigative procedures, research, and analysis, applies independent judgement and critical decision making to determine regulatory compliance risk to patients and the organization. The Analyst uses the advanced knowledge of the regulatory compliance profession, and research and auditing procedures. Uses professional verbal and written communication skills to document and communicate results and findings of compliance research, analysis and decision- making. Ensures health system compliance with applicable regulatory, accreditation and requirements. 1. Identifies, researches and analyzes compliance and regulatory risk Researches and collects all data points relevant to the issue being investigated. Using advanced knowledge of federal, state and local regulations, analyzes the actual and/or potential...

Location: Richmond, VA with travel to corporate office in Jacksonville, FL as necessary Schedule: Monday-Friday Pay Range: $60,000-80,000 per year, dependent on experience Be part of our growing regional company whose main objective is putting our patients first. The provider educator is responsible for identifying opportunities to improve coding, documentation and quality of care. The educator will customize an education plan customized for each provider. Position overview: Plan, conduct and coordinate all aspects of MRA process evaluation and education to internal and external partners, including but not limited to: Communicating a comprehensive understanding of Medicare Risk Adjustment, Documentation & Coding guidelines to both external/internal partners while ensuring compliance with regulatory. Analyze reports to identify and report documentation/coding trends in order to create opportunities for improvement with internal and external partners....

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or payer...

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. (60%) 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...

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...

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 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 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 guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these...

Job Description About the Role: We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact...