39 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...

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....

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.

Medical Coder (CPC / CPC-A) Bayview Physicians Group | Chesapeake, VA Full-Time | Experienced or Apprentice | Medical Billing Department Code with purpose. Grow with confidence. Build your future at Bayview. Bayview Physicians Group is a rapidly growing, outpatient multi-specialty medical group that believes exceptional healthcare starts with strong doctor–patient relationships. With hundreds of team members serving the Hampton Roads community, we are committed to excellence, collaboration, and creating a positive workplace where employees can thrive. We are currently seeking a Certified Professional Coder (CPC or CPC-A) to join our Medical Billing team. Whether you’re an experienced coder or an Apprentice ready to grow, this is an exciting opportunity to build your skills within a large, diverse, multi-specialty organization. We are willing to train the right candidate. Remote and hybrid opportunities are available. Why You’ll Love Working Here...

Job Title: Outpatient Medical Coder 3 Department: Health System Shared Services | MIM CDI and Coding Scope of Position Coding services assigns diagnosis and procedural codes to inpatient and outpatient medical records to facilitate the reimbursement and data collection for the individual business units of the OSU Health System. ICD-10-CM/PCS diagnoses and procedure codes are applied to inpatients and CPT-4 procedure codes are applied to all outpatients treated within the OSU Health System that are not captured through the charge description master. Medical record abstract data is assigned based on information reviewed for accuracy in IHIS during the coding process. Position Summary The position is responsible for coding medical records and other documents at the conclusion of the patient's visit. A senior medical records coding specialist requires the skill set to code multiple work types for inpatient and outpatient services (outlined below). This requires selection of...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

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 Job Summary Acentra Health is seeking a dedicated and detail-oriented Medical Coder to join our growing team.This is an instrumental Medical Coding role where you will play a key part in ensuring the accuracy and integrity of clinical...

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 to join our growing team. Job Summary: The Medical Coder reviews medical record documentation to assess the accuracy, completeness, and clinical support of reported diagnoses and...

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 ...

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 Coder Schedule: Full Time Weekdays Only. Location: This is an on-site office position. 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 of our community. We're proud to deliver high-quality, personalized care in a small-town setting, where strong provider-patient relationships are at the heart of everything we do. With clinics spanning...

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....

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...

Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

Responsibilities 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: 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...

The Lead Risk Adjustment Coder is a system support position who completes coding and abstracting of patient encounters for the purposes of analyzing and improving the accuracy of complexity capture. The specialist works closely with physicians, the Population Health quality and data teams, the coding teams in AMG and the hospital, and the compliance department to identify and deliver high quality and accurate risk adjustment coding. The Lead Risk Adjustment Coder will demonstrate strong understanding of ICD-10-CM, CPT, HCC, and HCPCS coding guidelines and practices for outpatient and inpatient coding. Education High school diploma or equivalent is required 2 years of completed college coursework is preferred Licensure/Certification Certified Professional Coder thru AAPC Certified in Risk Adjustment coding or willing to obtain within 6 months of hire Experience Proficient in ICD-10 coding with 3 years of experience in the outpatient or hospital coding...

Job Description Job Description Certified Medical Coder (Remote Production Role) Our mission to change wound care and improve the lives of others isn’t easy, but it’s worth it! One in ten residents in a skilled nursing facility will develop a skin condition requiring expert medical care. We believe that every person deserves the very best wound care. Building and leading wound care teams is how we do it! Our wound care providers bring education and encouragement to the people who take care of our patients 24/7. When they get better at their jobs, our patient’s wounds heal faster and that is our goal! *** We are accepting applications for potential future opportunities and do not currently have an open position *** Main Responsibilities (may include but are not limited to): Meet minimum production goals while maintaining accuracy requirements Review provider medical...

About the Job About the Job Our OBGYN practice is seeking to enhance our billing staff with the addition of a new full-time member to our dynamic team. The right candidate should possess a desire to provide high-quality customer service with efficiency and compassion. A growth mindset is vital in this position as we all have an opportunity to learn more every day. JOB SUMMARY: The Medical Coder is responsible for accurately assigning diagnosis, procedure, and modifier codes for obstetrics and gynecology services to ensure compliant billing and optimal reimbursement. This role requires in-depth knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines **specific to OBGYN is a plus** The Medical Coder works closely with providers, billing staff, and clinical teams to resolve documentation issues, reduce claim denials, and maintain compliance with federal, state, and payer regulations. ESSENTIAL JOB RESPONSIBILITIES : Review clinical documentation to accurately...

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 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...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate...

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...