90 coder certified jobs found

Riverside Health in Newport News, Virginia is seeking a skilled Medical Coder to assign ICD-10-CM and CPT codes to medical records, ensuring accurate documentation and compliant billing. You will review charts, identify gaps, and collaborate with physicians to obtain necessary information. The role emphasizes coding accuracy, productivity, and adherence to regulatory standards. Candidates with CPC or COC certifications and at least one year of coding experience are encouraged to apply; remote #J-18808-Ljbffr

Certified CoderAt Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.Requirements3+ years of direct experience in medical coding, medical billing, and/or coding quality assurance/auditing in a healthcare environment, including ICD-10-CM/PCS, CPT/HCPCS, and DRG/APR-DRG coding systemsActive coding...

Medical Record ReviewerThe 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 assignedRead, understand, and adhere to all corporate policies...

Req ID: RQ226381 Type of Requisition: Regular Clearance Level Must Be Able to Obtain: None Public Trust/Other Required: None Job Family: Ancillary Health Skills: Claims Data,Data Analysis,Microsoft Excel,Policy Analysis,Strategic Objectives Certifications: Certified Fraud Examiner (CFE) | Association of Certified Fraud Examiners (ACFE) - Association of Certified Fraud Examiners (ACFE) Experience: 8 + years of related experience Job Description: GDIT's Federal Health Division is hiring a Healthcare Coding Expert to support the Centers for Medicare and Medicaid (CMS), you will be trusted to identify trends in the data and create leads and referrals for the Healthcare Fraud Prevention Partnership (HFPP) members (Partner) and the Trusted Third Party (TTP). You will be part of a 50-person team supporting the TTP which was established in 2012 to reduce fraud, waste and abuse in healthcare data. Work expected to begin in October 2026 Work...

Riverside Health System in Newport News, VA is seeking a Certified Coder to assign ICD-10-CM and CPT codes, ensuring accurate documentation and proper reimbursement. You will review charts, outpatient records, and physician notes, then query clinicians as needed to resolve gaps and ambiguities. The role requires CPC or COC certification upon hire, at least 1 year of ICD-CPT coding experience, and the ability to work with physicians and billing staff to maintain coding quality and regulatory #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...

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.

Newport News, Virginia Hiring Range $27.30 - $37.58/HourlyActual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. FOR APPLICATION REVIEW - PROVIDE YOUR CODER CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME 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...

Job TitleNewport News, VirginiaHiring Range: $23.00 - $29.90/HourlyActual 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...

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...

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...

Medical Coder Venesco is seeking a detail-oriented Medical Coder to support clinical trials through accurate coding and reconciliation of medical data. Remote/Hybrid Full-Time 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

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...

Company DescriptionAmerica Networks is a leading sensor and networking solutions partner for companies in any Industrial, Manufacturing, and Waste management space. We design and manufacture sensors for storage tanks, water metering, energy metering, gas monitoring, and asset management. Our founders are hardcore telecommunications engineers with combined 200 + years of experience in designing, optimizing and performance engineering; for several mid – large wireless carriers internationally - that saw a need to provide low power, cost efficient sensors to collect data, create alerts, and predict needed actions. We have combined these sensors with low power, wide area (LPWA) networking technologies to provide clients various options to decrease re-occurring costs associated with operating an IoT network of sensors and connected devices. We specialize in design, deployment, optimization, and support of these Networks. Whether an off-the-shelf or custom solution is needed, we’ll...

Position: Junior Java Developer (Hands-on coder)Location: McLean, VirginiaDuration: ContractJob ID: 178957Job Overview: We are seeking a Junior-level Developer-Java/J2EE Professional with 3 to 5 years of experience to join a fast-paced team. The ideal candidate will be responsible for building rapid prototypes, MVPs, and experimental web tools using the latest AI coding assistants. This is an exciting opportunity for someone who enjoys learning new technologies, iterating quickly, and collaborating with AI to bring innovative ideas to life.Responsibilities:Utilize AI-powered development tools (e.g., Cursor, Windsurf, Claude Code, GitHub Copilot) for daily tasks.Engineer prompts to optimize AI coding output and manage tokens effectively.Develop and iterate web applications, APIs, and backend services using AI tools.Prototype new features, tools, and MVPs based on team and customer feedback.Debug and refine AI-generated code for reliability and usability.Experiment with emerging AI...

Corporate Coding and Compliance - Newport News, VA 23606 Overview Level Entry Position Type Full Time High School Travel Percentage None Category Coding and Compliance Description Position Summary A Coder I performs coding audits for quality checks and provider education. Major Duties and Responsibilities Maintains working knowledge of coding and compliance. Provides coding training and support to all TPMG locations. Participates in coding-related denial meetings. Performs coding and auditing of medical record documentation to ensure accurate coding. Reviews and submits documentation for all Recovery Audit Contractors (RAC) requests; timely follow-up of RAC audit. Reviews and submits documentation for all Error Rate Testing (CERT) requests with timely follow up of CERT response. Reviews and submits documentation for Targeted Probe and Educate (TPE) requests. Reviews and submits documentation for medical record requests for all insurance carriers. Follows HIPPA guidelines. Works...

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...

Inpatient CoderThe Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. This position performs the primary function of coding inpatient or outpatient records to include Ambulatory, ER and Miscellaneous Ancillary charges. Utilizes 3M Encoder to code and classify inpatient and/or outpatient records according to ICD-10. Responsible and accountable for maintaining performance skills. Key responsibilities include:Coding of inpatient/outpatient medical records in accordance with AHA Coding/NCCI compliance guidelines.Review medical records online and assign ICD-10-CM and CPT codes to inpatient and/or outpatient records.Ability to code inpatient and outpatient hospital records with a 95% accuracy rate.Consistently meets productivity standards in accordance with HIM Departmental guidelines.Maintains a coding proficiency rating consistent with HIM Departmental standards.Compliance with continued educational requirements necessary to maintain valid...

Inpatient Coder (Remote)Full-time • Work From HomeMust have CCS, RHIA, or RHIT certificationJob SummaryAs 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 QualificationsAssign, 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-PCSMaintain or exceed established accuracy standardsMaintain or exceed established productivity standardsUtilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGsUndergraduate (Associate's or Bachelor's) degree in HIM/HIT...

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...