26 inpatient complex coder jobs found

Summary About the Position: The positions fall under the Defense Health Agency (DHA) Atlantic Network at the Naval Medical Center Portsmouth, Patient Administration Department (PAD) providing guidance and functional expertise to improve coding accuracy, and functioning primarily as a medical auditor/trainer. (See duties below) . This is a Direct Hire Solicitation Learn more about this agency Duties Help Analyze patient medical records to identify inaccurately coded services in accordance with federal coding regulations and guidelines. Assign specific codes to medical records, sequencing and determining codes to accurately reflect the resources and procedures used in the care of the patients. Ensure compliance with regulatory and third-party insurance requirements in utilizing the ICD-10-CM, and CPT coding books. Perform limited utilization review of outpatient and inpatient records to assure the diagnosis responsible for the length of stay is...

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,...

Inova Health is looking for a dedicated Medical Records Coder Supervisor to join the Inpatient team. Full-time Day Shift: Monday-Friday, general office hours, working remotely. 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 spouses/partners, and their...

Medical Records Coder SupervisorInova Health is looking for a dedicated Medical Records Coder Supervisor to join the Inpatient team. Full-time Day Shift: Monday–Friday, general office hours, working remotely.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 Records CoderHorizon Health Corporation is seeking a Medical Records Coder for our brand new Crisis Receiving Center with 24 chairs in Richmond, VA. Accurately assigns diagnostic and procedural codes in a timely manner for all inpatient and partial patient charts. Updates/enters computerized patient abstract in the MS4 system. Assumes responsibility for preparing charts for quarterly audit. Backs up Supervisor as needed. Attends corporate coding training sessions. Primarily responsible for charting Discharge Summaries when they print off and filing the charts in the Perm Room if they are complete. Assists Records Technician in assembling charts when that task is backed up. Assists in picking up discharged charts and faxing the COCs each morning. Files charts in the Perm Room. This position requires critical thinking and problem-solving skills. Must be able to possibly work on a weekend due to an absence in the department. Other duties as assigned.Coding Inpatient...

Become a part of our caring community Become a part of our caring community and help us put health first *** $5,000 SIGN-ON BONUS for new associates! $5,000 payable following 90 days employment. *** The IPA Consultative Coding Professional provides medical coding expertise and consultative support to Independent Practice Association (IPA) affiliates nationwide. These affiliates include MSO-contracted independent providers. You will be the primary coding and documentation resource for assigned providers, supporting accuracy, compliance, and performance in risk adjustment and value-based care initiatives. You will analyze trends, triage, and answer questions in real-time, as well as research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. As an IPA Consultative Coding Professional, we will assign you a panel of up to 30 providers within a defined market or region. You will deliver ongoing education, support coding...

Medical Record Reviewer 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 corporate...

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. Duties Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final diagnoses accurately reflect care provided. Reviews provider documentation to ensure appropriate Evaluation and Management (E/M) levels and correct CPT code assignment. Assigns and sequences ICD, CPT, HCPCS, CDT, and DSM codes based on documented diagnoses and procedures. Ensures diagnostic and procedural terminology aligns with current medical nomenclature and...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Inova Systems Operations is looking for a dedicated Medical Records Coder 4 for Inpatient. This role will be full-time day shift with a negotiable schedule. 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: offeringup 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 spouses/partners, and...

Fully Remote Lake Park Building Full time R180631 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...

Our Medical Billing Specialists ensure efficient filing and resolution of insurance claims; acting as liaison between doctors, insurance companies, and patients. Essential Duties and Responsibilities include the following. Other duties may be assigned. Monitors and evaluates insurance reimbursements and requests review of questionable reimbursements on a claim-by-claim basis and by procedure code. Obtains accurate billing information from patients and insurance companies. Consults physicians and/or the coding department for assistance with the resubmission of claims requiring corrected diagnosis or procedure codes and as a resource for additional documentation or letters of inquiry and/or explanation, etc. Manages and researches status reports and the Aged AR to determine and resolve claim issues, denials, and overpayments. Works with insurance carriers and Privia to identify and address major claims issues and policy inconsistencies, escalating when necessary,...

Responsibilities Medical Records Coder (RHIT Registered Health Information Technician; CPC Certified Professional Coder; or CCS Certified Coding Specialist required)- Richmond, VA Horizon Health Corporation is seeking a Medical Records Coder for our brand new Crisis Receiving Center with 24 chairs in Richmond, VA. Accurately assigns diagnostic and procedural codes in a timely manner for all inpatient and partial patient charts. Updates/enters computerized patient abstract in the MS4 system. Assumes responsibility for preparing charts for quarterly audit. Backs up Supervisor as needed. Attends corporate coding training sessions. Primarily responsible for charting Discharge Summaries when they print off and filing the charts in the Perm Room if they are complete. Assists Records Technician in assembling charts when that task is backed up. Assists in picking up discharged charts and faxing the COCs each morning. Files charts in the Perm Room. This position requires...

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...

Inova Health is looking for a dedicated Certified IRC Coder to join the PB 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: offeringup 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 Billing Specialist Neurology Services, Inc., is looking to hire a full-time Medical Billing Specialist. The Medical Billing Specialist is responsible for posting charges and receipt of payment for all medical services rendered by Neurology Services, Inc. In this role you are held accountable for the management of the accounts, throughout the entire collections process. Prompt submission and follow-up of all claims are essential for success. Persistency is vital! Errors will result in slow payment and/or reduced and lost revenue. You will be supporting the founder and owner of Neurology Services, Inc., Dr. Peter Bernad, who offers effective and individualized treatments to correct a host of medical conditions. He is a board-certified physician and has broad experience in pediatric, medical and surgical care. The practice does not perform surgery but focuses on determining the basis or cause of a patient's problem. We treat patients with a wide variety of neurological...

Remote Medical CoderNewport News, VirginiaHiring Range: $23.00 - $29.90/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: 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...

Newport News, Virginia Hiring Range $23.00 - $29.90/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 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...

Job TitleNewport News, Virginia$23.00 - $29.90/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.OverviewEnsures 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 DoOrganizes 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...

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...

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.Primary DutiesPerforming audit functions for the identified encounters in a timely and accurate manner.Generating well-written deliverables and audit work papers.Outstanding verbal communication skills.Outstanding...

Certified CoderAt 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.Requirements3+ years of direct experience in medical coding, medical billing, and/or coding quality assurance/auditing in a healthcare environment, including ICD-10-CM/PCS, CPT/HCPCS, and DRG/APR-DRG coding systemsActive coding...

## 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,...

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...