48 coder specialist jobs found

Position Summary We are seeking an experienced Inpatient Hospital Coder – Denial Appeals Specialist to review, analyze, and write compelling appeals for coding and DRG-related denials. This position requires a strong understanding of inpatient coding guidelines, MS-DRG assignment, clinical documentation, payer policies, and reimbursement principles. Key Responsibilities Review inpatient coding and DRG denial cases to identify the reason for denial and determine the appropriate appeal strategy. Analyze medical records, coding, clinical documentation, and payer denial rationale. Write detailed, persuasive appeals addressing coding, sequencing, diagnosis/procedure assignment, and DRG-related denials. Apply ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting and other applicable coding standards. Evaluate MS-DRG assignments and identify discrepancies between the documented clinical circumstances and the payer's determination. Research and reference applicable coding...

Sacbar is seeking an experienced Inpatient Hospital Coder – Denial Appeals Specialist in Towson, MD to review and write compelling appeals for DRG-related denials. The role requires strong inpatient coding knowledge, MS-DRG assignment, clinical documentation, payer policies, and reimbursement principles. The candidate will analyze medical records, apply ICD-10-CM/PCS guidelines, and collaborate with CDIS and revenue cycle teams to strengthen appeals. #J-18808-Ljbffr

A healthcare staffing agency is seeking a Certified Medical Coder to work remotely. This role involves reviewing medical records and coding diagnoses and procedures using ICD-9-CM and CPT-4 conventions. The ideal candidate should have extensive experience in inpatient and DRG auditing, knowledge of medical coding systems, and effective communication skills. Benefits include medical, vision, and dental insurance, a 401K plan, and an employee referral bonus, among others. #J-18808-Ljbffr

LifeBridge Health is seeking a medical coder to review, code, and abstract inpatient medical records in alignment with ICD-10-CM/PCS guidelines. You will assign diagnoses and procedures, then group codes into DRGs to support accurate hospital reimbursement. Qualified candidates hold an associate degree or higher in health information management or related field, with knowledge of coding principles and the ability to review records precisely. #J-18808-Ljbffr

LifeBridge Health is seeking an experienced Outpatient Medical Coder for a fully remote role. The coder will review, code, and abstract outpatient records with ICD-10-CM/PCS and CPT, supporting accurate reimbursement and compliance across ER, infusion, and other outpatient services. The ideal candidate has 1–3 years of outpatient coding experience, strong guideline knowledge, and can work independently in a remote environment. Certifications CCS/COC/RHIA/RHIT are required. #J-18808-Ljbffr

RELI Group, Inc. is seeking an experienced Senior Medical Coder in Baltimore, MD. You will support Medicare Part C Risk Adjustment Data Validation initiatives, performing diagnosis coding across various care settings. The ideal candidate will have a minimum of five years of coding experience and be a certified coder. The role offers an annual salary range of $60,000 to $80,000 based on skills and experience. Join a team that values expertise and impact. #J-18808-Ljbffr

RELI Group, Inc. is seeking a Senior Medical Coder to support Medicare Part C RADV initiatives. The role requires extensive ICD-9-CM/ICD-10-CM coding across inpatient, outpatient, and physician office encounters, with emphasis on documentation quality and attestation. The ideal candidate will have 5+ years of coding experience, hold CPC/CCS/RHIA/RHIT credentials, and be able to perform intake reviews, disputes, and QA activities while maintaining strict confidentiality and high accuracy in a #J-18808-Ljbffr

Medical Coding Auditor Hybrid (1 - 2 days in office per week) Baltimore, MD 21201 Compensation $66k-$92k Direct Placement Description Responsible for conducting independent physician coding and auditing reviews to ensure the accuracy, completeness, and compliance of medical record documentation supporting codes selected by providers and/or coders. This role ensures compliance with CMS guidelines, CPT, HCPCS, and ICD-10 code sets, while supporting providers through ongoing physician coding education, auditing feedback, compliance guidance, and training initiatives. This position plays a key role in physician documentation improvement, coding compliance, audit readiness, and provider education across the organization. Core Responsibilities Conduct independent physician coding and auditing reviews to assess the adequacy of medical record documentation supporting codes selected by providers and/or coders. Perform detailed physician coding compliance audits to ensure adherence...

Medical Coding Auditor Hybrid (1 - 2 days in office per week) Baltimore, MD 21201 Compensation: $66k-$92k Direct Placement Description Responsible for conducting independent physician coding and auditing reviews to ensure the accuracy, completeness, and compliance of medical record documentation supporting codes selected by providers and/or coders. This role ensures compliance with CMS guidelines, CPT, HCPCS, and ICD-10 code sets, while supporting providers through ongoing physician coding education, auditing feedback, compliance guidance, and training initiatives. This position plays a key role in physician documentation improvement, coding compliance, audit readiness, and provider education across the organization. Core Responsibilities Conduct independent physician coding and auditing reviews to assess the adequacy of medical record documentation supporting codes selected by providers and/or coders. Perform detailed physician coding compliance audits to ensure adherence...

Lehighbar is seeking an experienced Inpatient Hospital Coder – Denial Appeals Specialist to review, analyze, and write compelling appeals for coding and DRG-related denials in Towson, MD. The role requires mastery of inpatient coding guidelines, MS-DRG methodology, and payer policies. The ideal candidate has 2–5 years of inpatient coding experience, with strong ICD-10-CM/PCS knowledge and proven ability to craft persuasive appeals. #J-18808-Ljbffr

Job Title Responsible for conducting independent physician coding and auditing reviews to ensure the accuracy, completeness, and compliance of medical record documentation supporting codes selected by providers and/or coders. This role ensures compliance with CMS guidelines, CPT, HCPCS, and ICD-10 code sets, while supporting providers through ongoing physician coding education, auditing feedback, compliance guidance, and training initiatives. This position plays a key role in physician documentation improvement, coding compliance, audit readiness, and provider education across the organization. Hybrid Work Expectations To ensure collaboration, provider engagement, and training effectiveness, this position follows a hybrid work model with the following expectations: Mandatory in-office presence at least 1 day per week (Wednesday). Additional in-office days may be required for: Training sessions Provider meetings Department meetings Some weeks may require 2 days onsite...

Job Summary Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior. Codes and abstracts inpatient medical records of all types and, following a rigorous review of the clinical documentation, abstracts and assigns appropriate ICD-10-CM/PCS code sets and assigns the correct APR-DRG into the hospital information system. May also code other work types as assigned by the Coding Manager. Essential Functions: Determines the correct principal diagnosis, identifies and assigns co-morbidities and complications, secondary diagnoses, present on admission indicators for ICD-10-CM and MHACs (Maryland Hospital Acquired conditions), principal procedure codes and secondary procedure codes. Assigns the appropriate APR-DRG. Works in collaboration with CDI to ensure...

Job Summary: Position is remote within the local area. Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign. HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente...

Job Requirements Senior Inpatient Coder - Remote Monday - Friday 6AM-6PM ET (40 hours/week) Under direct supervision, accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. Analyzes, codes and abstracts complex inpatient cases such as trauma, rehab, neurology, critical care, etc.utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment. Utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as...

Position Overview The Senior Medical Coding Specialist acts as an internal expert to ensure that value‑based reimbursement and medical policy models are developed and implemented to support Payment Integrity. This role provides expert knowledge to support effective partnership with provider entities, guidance on the appropriate quality‑measure capture and proper use of CPT and ICD‑10 codes in claims submissions. The specialist utilizes coding expertise, combined with medical policy, credentialing and contracting rules knowledge, to build effective guidelines and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. This role also provides expertise and mentoring to other team members and will sit within the Payment Integrity team. Essential Functions Consult on proper coding rules in value‑based contracts to ensure appropriate quality‑measure capture and proper use of...

nTech Workforce has an immediate 22913 Certified Medical Coder Terms of Employment W2 Contract, 5 Months Location: Remote Overview 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. Responsibilities 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-...

Outpatient Medical Coder (100% Remote) Sign-On Bonus: Eligible for a $10,000 sign-on bonus. Remote Work Eligibility: Applicants must reside in one of the following locations: District of Columbia, Maryland, Pennsylvania, Virginia, or West Virginia We are seeking an experienced Outpatient Medical Coder to join our team in a fully remote capacity. The successful candidate will be responsible for accurately reviewing, coding, and abstracting outpatient medical records in accordance with established coding guidelines and regulatory standards. This position supports accurate reimbursement, quality reporting, and compliance through timely and precise medical coding. Key Responsibilities: Review outpatient medical records to identify documented diagnoses and procedures. Assign accurate ICD-10-CM/PCS and CPT codes in accordance with established coding guidelines. Code and abstract a diverse range of outpatient encounters, including emergency department (ER), infusion, and...

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...

100% REMOTE OPPORTUNITY SIGN-ON BONUS ELIGIBLE - UP TO $10,000 Eligible Remote States: District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia Key Responsibilities: Review, code, and abstract inpatient medical records in accordance with established coding guidelines and conventions. Assign accurate ICD-10-CM and ICD-10-PCS diagnosis and procedure codes. Determine and assign Diagnosis-Related Groups (DRGs), including CMS-DRGs and APR-DRGs. Review physician documentation to accurately identify and capture diagnoses and procedures for coding. Maintain coding accuracy and ensure compliance with organizational and regulatory standards. Qualifications: Associate degree or equivalent education in a specialized field required. One (1) to three (3) years of inpatient coding experience. One of the following certifications is required: Certified Coding Specialist (CCS) Certified Coding Associate (CCA) with five (5) or more years of coding experience...

Job SummarySupports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior.Codes and abstracts inpatient medical records of all types and, following a rigorous review of the clinical documentation, abstracts and assigns appropriate ICD-10-CM/PCS code sets and assigns the correct APR-DRG into the hospital information system. May also code other work types as assigned by the Coding Manager.Essential Functions:Determines the correct principal diagnosis, identifies and assigns co-morbidities and complications, secondary diagnoses, present on admission indicators for ICD-10-CM and MHACs (Maryland Hospital Acquired conditions), principal procedure codes and secondary procedure codes.Assigns the appropriate APR-DRG.Works in collaboration with CDI to ensure that the MHACS...

Job Description Job Description Moore OB/GYN is seeking an experienced and detail-oriented Certified Medical Billing & Coding Specialist to join our growing team. The ideal candidate will have strong OB/GYN coding knowledge, payer compliance expertise, and the ability to manage accounts receivable efficiently. Position: Certified Medical Biller/Coder Employment Type: Full-Time Location: Forestville – Maryland Key Responsibilities: Accurate CPT, ICD-10, and HCPCS coding (OB/GYN focus) Review and submission of claims (commercial, Medicaid MCOs MD/DC ) Manage denials, appeals, and AR follow-up Verify patient eligibility and benefits Ensure compliance with payer policies (UHC, CareFirst, JHHP, MD/DC Medicaid, etc.) Work within EMR/PM system  Apply appropriate modifiers (25, 59, 51, etc.) Monitor payer updates and policy changes Qualifications: CPC, CCS, or equivalent certification (Required) Minimum 5 years medical billing/coding...

Job Summary: Position is remote within the local area. Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for reimbursable accounts for all internal and external surgical services. Serves as a technical coder for all specialties. Assists supervisor in responding to coding questions from other levels of coders and in responding to providers. Conducts special projects and focused reviews of encounters as requested. Essential Responsibilities: Required to research and assign. HCPCS Level II codes for ambulatory surgical services and/or professional services performed. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente...

CareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire. The role involves verifying diagnosis codes and maintaining coding guidelines. Candidates should have at least 3 years of relevant coding experience and be adaptable to various technology platforms. Position offers a hybrid work model, allowing some remote work. Salary ranges from $51,984 to $95,304 with a comprehensive benefits package. #J-18808-Ljbffr

Eligible Remote States District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia Key Responsibilities Review, code, and abstract inpatient medical records in accordance with established coding guidelines and conventions. Assign accurate ICD-10-CM and ICD-10-PCS diagnosis and procedure codes. Determine and assign Diagnosis-Related Groups (DRGs), including CMS-DRGs and APR-DRGs. Review physician documentation to accurately identify and capture diagnoses and procedures for coding. Maintain coding accuracy and ensure compliance with organizational and regulatory standards. Qualifications Associate degree or equivalent education in a specialized field required. One (1) to three (3) years of inpatient coding experience. One of the following certifications is required: Certified Coding Specialist (CCS) Certified Coding Associate (CCA) with five (5) or more years of coding experience Registered Health Information Technician (RHIT) Registered Health Information Administrator...