114 coder professional 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...

Overview 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. Learn more about career opportunities on our Careers Page. 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...

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 documentation opportunities and queries clinical staff to fill in any gaps to clarify confusing, incomplete or conflicting information and obtain any needed additional documentation. Contacts and works with physicians as needed for clarification of details to ensure correct coding. Accurately utilizes the ICD‑10‑CM...

Certified Coder 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. The Atlantic Region CBO is seeking a dynamic and talented Certified Coder. The primary responsibility of the Coder is to assist the CBO with the review of medical records, assign ICD-10 and CPT codes to Inpatient or Outpatient records as needed, meet productivity requirements and meet all legal (federal and state) coding requirements. Key Responsibilities include: Analyze and evaluate medical records and assign appropriate ICD-10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Reviews APC edits and add modifiers or delete charges as needed Consult with hospital staff when necessary to secure sufficient information to clarify data for proper coding and resolve discrepancies...

Job Description Job Description About Us: Dominion Women’s Health is dedicated to delivering high-quality healthcare services with accuracy, efficiency, and integrity. We are seeking a detail-oriented and knowledgeable Medical Coder to join our team on-site and play a critical role in ensuring proper coding and billing practices. As a part of our team, all employees must maintain strict confidentiality and adhere to all HIPAA and OSHA regulations to ensure patient privacy and workplace safety. Qualifications: Certified Professional Coder or Certified Professional Coder Apprentice 1–2 years of coding experience preferred (newly certified candidates may be considered). Strong knowledge of ICD-10, CPT, and HCPCS coding guidelines. Ability to work independently with strong attention to detail. Excellent communication and organizational skills. Must be willing to submit to a background investigation, including for example, verification of your past employment, criminal...

Certified Coder 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. The Atlantic Region CBO is seeking a dynamic and talented Certified Coder. The primary responsibility of the Coder is to assist the CBO with the review of medical records, assign ICD-10 and CPT codes to Inpatient or Outpatient records as needed, meet productivity requirements and meet all legal (federal and state) coding requirements. Key Responsibilities include: Analyze and evaluate medical records and assign appropriate ICD-10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Reviews APC edits and add modifiers or delete charges as needed Consult with hospital staff when necessary to secure sufficient information to clarify data for proper coding and resolve discrepancies in the...

Coder The Atlantic Region CBO is seeking a dynamic and talented Coder. The Coder is responsible for reviewing medical records and assigning ICD-10-CM and CPT codes to Inpatient and/or Outpatient records. Key responsibilities include: posting charges and level emergency room visits, abstracting medical, demographic and other information from the medical record and entering data into hospital wide information system, meeting coding standards and daily productivity. Other duties as assigned. Benefit highlights include: challenging and rewarding work environment, competitive compensation & generous paid time off, excellent medical, dental, vision and prescription drug plans, 401(K) with company match and discounted stock plan, SoFi student loan refinancing program, and career development opportunities within UHS and its 300+ subsidiaries! Qualifications: high school diploma or equivalent, 2 years coding experience in ICD-10-CM and CPT-4. Computer/keyboard skills, knowledge of...

HCA Healthcare, Inc. is seeking a Trauma Surgical Profee Coder in Richmond, Virginia. As a Profee Coder, you will review and code clinical notes and operative reports, ensuring compliance with coding guidelines while providing feedback to physicians and the coding team. The ideal candidate will have a minimum of two years of experience in fee coding, possess medical terminology knowledge, and hold a coding certification from AHIMA or AAPC. This role offers comprehensive benefits including medical coverage, tuition assistance, and more. #J-18808-Ljbffr

Job Title Newport News, Virginia 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. Hours: Labor Pool (as needed) 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 documentation opportunities and queries clinical staff to fill in any gaps to clarify confusing, incomplete or conflicting information and...

Chesapeake Regional Healthcare in Chesapeake, Virginia, is seeking a skilled Medical Coder to manage coding and billing processes effectively. The ideal candidate will possess a Certified Professional Coder Certificate and have experience in healthcare billing and coding. This role includes updating fee schedules, assigning correct codes for claims, and ensuring compliance with regulations. Strong organizational and communication skills are vital for success. Join us to make a significant impact in patient care. #J-18808-Ljbffr

Medical Coding Specialist 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 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 assigned Read, understand, and adhere to all...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Riverside Medical Group in Newport News, Virginia is seeking a Coder to ensure accurate coding and reimbursement capture. The position is remote work eligible for candidates in various states, including Virginia. We offer a supportive environment where you will work closely with clinical staff and mentors to ensure correct coding practices. The ideal candidate will have a High School Diploma or GED, along with CPC or COC certification. Strong experience with ICD-10-CM and CPT coding is essential for success. #J-18808-Ljbffr

Summary Monday through Friday 8:00 AM to 4:30 PM GENERAL SUMMARY Under general supervision, the Hospital Medical Coder II is responsible for the collection of relevant, pertinent, accurate and timely profile data configured and/or abstracted from the hospital’s outpatient, observation, day surgery, urgent care and emergency records moving from the least complex to the most complex. This position may be responsible for coding inpatient records as needed/requested by management; this includes effective use of relevant coding systems as well as recognizing what data can be abstracted, presented and interpreted for effective use throughout the hospital network. Reports to department management. ESSENTIAL DUTIES AND RESPONSIBILITIES Uses established coding guidelines to ensure the most effective and accurate coded profile on the patient. Abstracts pertinent and accurate data from the clinical record. Works with hospital and clinical staff to ensure that accurate and relevant patient...

Medical Coder Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented team. Job Location: Richmond, VA About the Role: We are seeking experienced Medical Coders to support post-market surveillance and adverse event case processing tied to FDA reporting requirements. This is a unique, high-priority role supporting consumer products, including nicotine and tobacco products. You will work directly within our existing complaint database—not a contractor-managed system—to ensure timely continuity of daily operational workflows. Key Responsibilities: Perform MedDRA coding on adverse event reports derived from consumer complaints. Conduct seriousness, severity, and expectedness assessments for each case. Identify potentially reportable serious adverse events in compliance with FDA requirements. Process daily consumer complaints within the client's...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Universal Health Services is seeking a Certified Coder for the Atlantic Region Central Billing Office in Richmond, VA. The primary role includes reviewing medical records and assigning ICD-10 and CPT codes, ensuring compliance with legal standards. The ideal candidate will have a High School Diploma or equivalent and coding credentials (CPC or CCS). Benefits include competitive compensation, health plans, and opportunities for career development within UHS and its subsidiaries. #J-18808-Ljbffr

Introduction Do you want to join an organization that invests in you as a Trauma Surgical Profee Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Benefits Candidates with Trauma/Surgical Profee experience are strongly preferred. Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long‑term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and...

Inpatient Coder The 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...

Coder Position The Atlantic Region CBO is seeking a dynamic and talented Coder. The Coder is responsible for reviewing medical records and assigning ICD-10-CM and CPT codes to Inpatient and/or Outpatient records. Key responsibilities include: posting charges and level emergency room visits, abstracting medical, demographic and other information from the medical record and entering data into the hospital wide information system, meeting coding standards and daily productivity, and other duties as assigned. Benefit highlights include a challenging and rewarding work environment, competitive compensation and generous paid time off, excellent medical, dental, vision and prescription drug plans, 401(k) with company match and discounted stock plan, SoFi student loan refinancing program, and career development opportunities within UHS and its 300+ subsidiaries. More information is available on our benefits guest website: benefits.uhsguest.com. Qualifications Job requirements include...

Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...