15 coding auditor senior jobs found

## Description**Capital Area Health Network (CAHN)***Richmond, VA - On-Site Position*Make a real impact with Capital Area Health Network (CAHN), a dynamic and growing Federally Qualified Health Center (FQHC) located in the heart of Richmond, VA. We're expanding our team and seeking talented, mission-driven professionals who want to elevate community health. At CAHN, we innovate, we serve with purpose, and *we are just better.* Step into a role where your work creates lasting change.-**Our Core Values****Compassion** - We treat every person with dignity and fairness, ensuring no one feels alienated or discriminated against.**Accountability** - We safeguard confidentiality and remain transparent with all stakeholders.**Reverence** - We are called to serve and uplift those in need while fostering mutual respect.**Excellence** - We commit to continuous learning to deliver culturally responsive, high-quality care.**Stewardship** - We manage resources responsibly for the benefit of our...

Risk Adjustment CoderSentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!Hours: Monday - Friday, 8:00AM -5:00PM, dayshift.This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration.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...

Risk Adjustment CoderLocation: Virginia Beach, VA Work Shift: First (Days)Overview: Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA! Hours: Monday - Friday, 8:00AM -5:00PM, dayshift. This is a hybrid position that offers a combination of remote and onsite work, with a requirement to be in the office one to two days each week. The role also includes travel as needed to support business objectives and team collaboration.Responsibilities: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...

## 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,...

Exceptional inpatient coding quality has a direct impact on patient care, reimbursement integrity, research initiatives, and the accuracy of healthcare data. This leadership-oriented coding opportunity allows an experienced inpatient coding professional to serve as a trusted expert, mentor, and quality champion within one of the nation's leading academic health systems. If you've progressed beyond production coding and enjoy auditing, education, solving complex coding challenges, and helping others succeed, this role offers the opportunity to make a meaningful impact while working with highly specialized cases and some of the most advanced programs in healthcare. The Role As the Clinical Coding Coordinator (Lead Coder) for Hospital Inpatient Coding, you will serve as the team's primary subject matter expert and quality resource. This is not a traditional production coding role. Instead, you will be the expert consultants turn to when complex questions arise, helping ensure...

Capital Area Health Network (CAHN) in Richmond, VA is seeking a Senior Certified Coder with FQHC expertise to ensure accurate outpatient coding across primary care, behavioral health, dental, and preventive services. The role requires CPC/CPC-H/CPC-P or RHIT certification and 5+ years of coding experience, including FQHC settings. You will review documentation, mentor team members, and support audits and revenue cycle initiatives, working on-site with a focus on compliance and payer requirements. #J-18808-Ljbffr

Job Title 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, monitoring, & auditing, control assessment, reporting, investigation, root cause analysis, and corrective action oversight. Performs vendor quality oversight audits; reviews and/or makes final coding determination for...

Exceptional inpatient coding quality has a direct impact on patient care, reimbursement integrity, research initiatives, and the accuracy of healthcare data. This leadership-oriented coding opportunity allows an experienced inpatient coding professional to serve as a trusted expert, mentor, and quality champion within one of the nation's leading academic health systems. The Role As the Clinical Coding Coordinator (Lead Coder) for Hospital Inpatient Coding, you will serve as the team's primary subject matter expert and quality resource. This is not a traditional production coding role. Instead, you will be the expert consultants turn to when complex questions arise, helping ensure the highest standards of coding accuracy, compliance, and reporting integrity. In this completely remote role you’ll work closely with coding professionals across the organization, providing guidance, education, quality oversight, and support for highly complex inpatient cases. Your expertise will...

DRG Coding Auditor - MS-DRG and APR-DRGSign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service.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. Alternate locations may be considered if candidates reside within a commuting distance from an office.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.The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients....

Sentara Health Plans in Virginia Beach, VA is seeking a Risk Adjustment Coder to perform compliance activities related to CMS/HHS risk adjustment and RADV audits. You will review professional and facility coding to ensure accurate HCC capture and support vendor and internal audits. The role requires an Associate degree or 4 years of coding experience, knowledge of ICD-10-CM guidelines, and CRC certification within two years. #J-18808-Ljbffr

DRG Coding Auditor - MS-DRG and APR-DRGSign On Bonus: $1,500Virtual: 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. Alternate locations may be considered if candidates reside within a commuting distance from an office.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.The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation...

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-Inpatient to join our growing team. Job Summary: The Medical Coder is responsible for reviewing inpatient medical record documentation to ensure the accuracy, completeness, and...

Supervisor- Emergency Transport-Prince William Medical Center Job Description Job Code: SU2000 Full Time Days/Mid-shifts FLSA Status: Non -Exempt About Us We are welcoming a new era in healthcare where achieving good health is just the beginning. AtUVACommunity Health, we believe in caring for the whole person by getting to know – and making connections with – our patients. By combining the talent andexpertiseof our people, the breadth of capabilities across our system, and our commitment to helping our communities get better and stay healthy, we are improving the patient experience. As aUVACommunity Healthteam member, you will have a voice in patient care decisions, support the most advanced medicaltechnologiesand llena strong senseof satisfaction from making a difference in people’s lives every day. Job Summary The Supervisor, Emergency Transport provides day-to-day operational and clinical oversight of ambulance and patient transport servicesfor assigned site...

Chesapeake Regional Medical Group is seeking a Senior Coding Specialist to perform coding tasks across physician practices, including obtaining pathology and operative reports, assigning ICD and CPT codes, and ensuring accurate transmissions within the system. The role requires experience in hospital/medical office settings, CPC certification (or within one year), and strong computer skills. You will participate in audits, education, and go-live support across multiple locations. #J-18808-Ljbffr

Coding Specialist (Part-Time)At 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.The Coder Reviewer position is responsible for supporting and conducting reviews and determinations for independent dispute resolutions at both the Federal and State levels. Subject matter expert in clinical...