52 coder specialist 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

CenterWell Senior Primary Care is seeking an IPA Consultative Coding Professional to provide coding expertise and support to independent providers. The role involves collaborating with clinicians to ensure accurate diagnostic coding and compliance, while delivering education based on trends and best practices. The ideal candidate will have over 3 years of experience in risk adjustment medical coding and must hold a valid certification. A hybrid work model is offered, with a requirement to be located within 50 miles of Chesapeake, Virginia. #J-18808-Ljbffr

Riverside Health in Newport News, Virginia, is seeking a Medical Coder to assign ICD-10-CM and CPT codes for claims and ensure accurate reimbursement. The role requires organizing documents, auditing records, and querying clinicians to fix gaps, with a target coding accuracy of 90% or higher. The ideal candidate holds a high school diploma or GED, has 1 year ICD-1 coding experience, and will need CPC or COC certification upon hire. #J-18808-Ljbffr

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

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...

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...

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...

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...

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 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...

## Risk Adjustment CoderApplyremote type: Hybridlocations: SMG Administrationtime type: Full timeposted on: Posted Todayjob requisition id: JR-103351**City/State**Virginia Beach, VA**Work Shift**First (Days)**Overview:**# **Overview**Performs 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,...

Sentara Health in Virginia Beach, VA is seeking a Medical Coding Specialist II to perform accurate and compliant coding across multiple specialties, supporting revenue cycle operations and ensuring timely, accurate billing. The ideal candidate has at least 5 years of coding experience, CPC or CCS certification, familiarity with Epic, GECB, or Allscripts, and a strong grasp of the full revenue cycle from terminology to collections. #J-18808-Ljbffr

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...

Medical Billing SpecialistPosition: Medical Billing Specialist Location: Remote / On-site Department: Revenue Cycle Management Overview: CMCI is seeking a detail-oriented and experienced Medical Billing Specialist to oversee claims processing, revenue cycle management, and contribute valuable insights to develop AI-powered tools that enhance medical billing workflows. The ideal candidate will have expertise in medical coding, claims submission, payer interactions, and denial management, ensuring optimized billing practices for maximum reimbursement and minimal claim rejections. Why Join CMCI? Opportunity to work with cutting-edge AI-driven billing solutions that optimize RCM efficiency. Work in a collaborative environment with healthcare and AI professionals. Competitive salary, benefits, and professional development opportunities. Key Responsibilities: Claims Processing & Submission: Accurately process, review, and submit medical claims. Verify CPT, ICD-10, and HCPCS codes to...

Inpatient Coder (Remote) Full-time Work From Home Must have CCS, RHIA, or RHIT certification Job Summary As 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 Qualifications Assign, 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-PCS Maintain or exceed established accuracy standards Maintain or exceed established productivity standards Utilize the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGs Undergraduate (Associate's or Bachelor's)...

Inpatient Coder II Newport News, Virginia Hiring Range: $27.30 - $37.58/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. 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 deadlines. What You Will Do: Assigns International Classification of Diseases...

JOB SUMMARY : The Medical Coding Specialist is responsible for providing billing analysis of claims and applying coding standards and federal regulations to ensure correct billing practices. In this role, you will perform bill and chart reviews to identify any variation from quality billing practices and monitor patient bills for accuracy and compliance. This position also requires awareness of international coding systems and healthcare billing practices to support global operations and ensure alignment with international regulatory standards. JOB ROLES AND RESPONSIBILITIES: Review and analyze inpatient, outpatient, and provider billing for medical appropriateness of treatment; analyze charges across various revenue centers with consideration to patient diagnosis, procedures, age, facility type, and international healthcare norms where applicable. Apply recommendation of national coding and international coding and regulation standards (e.g., ICD-10-AM, OPCS-4,...

*TekSystems is currently hiring for a FULLY REMOTE ED **Senior** Medical Coder! * *MUST HAVE: Several years of ED Medical Coding experience! Must be certified in either: One of the following credentials are required - CCS, CPC, COC, RHIA, RHIT. Successful completion of a coding certificate program with AHIMA approval status is preferred. Must have EPIC Experience! * *States Approved: NC, TX, FL, VA! * *Description* The Senior Coding Specialist is responsible for accurately assigning and sequencing ICD diagnostic and procedural codes and/or CPT procedural codes to inpatient and outpatient records. Essential Duties and Responsibilities Code diagnostic and procedural information from the record using ICD-10-CM/PCS and CPT-4/HCPCS classification systems. Utilize a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM, Uniform Hospital Data Set, Medicare, Medicaid, and other fiscal intermediary guidelines. Work...

Hospital Inpatient Coding SpecialistThe 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.ResponsibilitiesAssigns diagnosis and procedure codes.Verifies accuracy of DRGAccurately abstracts required...

Medical Auditor (Billing & Coding)Previous coding experience required Hybrid - must be able to travel by car to regional officesResponsible for conducting coding and documentation audits for assigned providers and consulting and educating providers on documentation requirements and other compliance issues related to billing.Under the direct supervision of the Billing & Coding Compliance Manager, this full-time position will work with physicians and other clinicians to ensure they comply with documentation and coding standards, regulations and requirements. This includes conducting billing and coding audits, identifying and resolving issues, and educating clinicians and staff on requirements for documenting, coding and billing medical services.Job Responsibilities and Accountabilities:Assists with monitoring of OrthoVirginia's Compliance Program as related to billing, coding, and documentation, including the OIG Compliance Program guidance for physician practices and...

A regional healthcare organization in Virginia is seeking a Hospital Inpatient Coding Specialist to review inpatient medical records and assign appropriate diagnosis and procedure codes. The ideal candidate should have 2+ years of acute care coding experience, relevant certifications, and the ability to work independently. Strong attention to detail and proficiency in coding guidelines are required. The position may involve remote work and offers a collaborative environment with clinical specialists. #J-18808-Ljbffr

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...