51 medical physician coder jobs found

GI Coder III Required Skills & Experience Must Haves: 5+ years of professional medical coding experience Coder III level experience Extensive GI coding experience Experience coding: Colonoscopies EGDs (Esophagogastroduodenoscopy procedures) Other GI surgical procedures Experience in: Endoscopy Suites Ambulatory Surgery Centers (ASCs) EPIC experience required Experience with coding encoders such as: Codify Encoder Pro Experience using ProVation Nice to Have Skills & Experience Nice to Haves: Academic medical center experience Experience supporting system conversions or EMR transitions Job Description The GI Coder III is responsible for reviewing and assigning accurate ICD-10, CPT, and HCPCS codes for a variety of gastroenterology procedures and services. This individual will analyze physician documentation, operative reports, endoscopy reports, and related medical records to ensure coding accuracy, compliance, and appropriate reimbursement. The ideal...

Responsibilities Atlantic Region CBO: The Atlantic Region Central Billing Office (“ARCBO”) or (“CBO”) provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals. https://jobs.uhs.com/atlantic-region-cbo The Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. The primary responsibility of the DRG Coder is to analyze third party coding audits of paid claims, draft detailed appeal letters, evaluate clinical level of care and review denial trends. Key Responsibilities include: Perform DRG (Diagnosis Related Group) validation reviews in response to audits from third party payers. Review audit findings letters from third party payers to obtain a clear understanding of audited diagnosis codes and underlying payer clinical / coding rationale. Analyze medical records to obtain supporting clinical documentation...

City/State Norfolk, VA Work Shift First (Days) Overview Compliance Coding Auditor Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within...

The Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and educations associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider (MD/DO, APP, and other non-physician practitioners) organizations remains in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance. MINIMUM QUALIFICATIONS EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR ; Associate’s Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding. Current certification in one of the following: Certified Professional Coder (CPC)through the American Academy of Professional Coders (AAPC) Registered Health...

$40,000 - $45,000 a year About the Role We are seeking an Ambulance and NEMT Billing Coding Specialist to support the revenue cycle for emergency and nonemergency medical transportation services. This position reviews transport documentation, confirms patient and payer information, resolves documentation gaps, prepares accurate claims, and helps move each trip from intake through claim submission and follow-up. The ideal candidate is organized, detail-oriented, comfortable working independently, and able to collaborate with billing leadership, QA and QI staff, dispatchers, field personnel, facilities, transportation brokers, patients, and families. What You Will Do Review ambulance and NEMT transport records for completeness, accuracy, medical-necessity support, and consistency across dispatch records, ePCRs, trip documents, and billing systems. Verify patient demographics, insurance eligibility, payer order, transport type, service level, origin and destination, mileage,...

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:Sentara Medical Group is now hiring a full-time hybrid Risk Adjustment Coder in Virginia Beach, VA!Hours: Monday - Friday, 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 or must be able to do site visits. The role also includes travel as needed to support business objectives and team collaboration.OverviewPerforms 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...

At OrthoVirginia, you’re part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia’s largest provider of musculoskeletal care, we offer full‑time and part‑time opportunities in a collaborative, team‑oriented environment. With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non‑surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive. Join us and become part of a trusted network committed to excellence in orthopedic care. Primary Functions & Responsibilities: Analyze and interpret patient medical records, visit encounters, and reports to assign and sequence appropriate codes upon reviewing billed information. Ensure ICD-10, CPT, and HCPCS codes...

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. The Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. This...

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

The Enterprise Compliance Auditor/Educator will assist with the implementation and facilitation of ongoing compliance auditing, monitoring, and educations associated with all provider services across WVUHS and its affiliates. The duties of this position will help ensure that all healthcare provider (MD/DO, APP, and other non-physician practitioners) organizations remains in compliance with all federal healthcare program rules, regulations, administrative requirements and guidance. MINIMUM QUALIFICATIONS EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR ; Associate’s Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding. Current certification in one of the following: Certified Professional Coder (CPC)through the American Academy of Professional Coders (AAPC) Registered Health...

## Coder-Outpatient - (On-site)Applylocations: North Complextime type: Full timeposted on: Posted Todayjob requisition id: JR2353Coder-Outpatient - (On-site)7650 Revenue Cycle Management**Schedule:** Day Shift. 40 hours weekly. 7:00 am to 3:30 pm.**About the Position**This position has the responsibility for providing accurate, complete, and appropriate coding using ICD-10-CM/PCS and CPT classification systems for the Richmond and Connersville locations. Assigns appropriate APC grouping according to diagnoses specified in the record by the treating provider(s) and in keeping with regulatory requirements. Abstracts relevant clinical and demographic information from the medical record.**Overview of Responsibilities**• Codes outpatient medical records for the purpose of quality planning and assessment, reimbursement, research and compliance with Federal regulations according to ICD-10-CM and CPT-4 classification systems. • Accurately performs data entry/abstraction on all...

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...

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...

Fully Remote Lake Park Building Full time R182990 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,...

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...

Coding Specialist IIIInsight Global is seeking an experienced Coding Specialist III specializing in Cardiology, Cardiac Surgery, Thoracic Surgery, and Vascular Surgery coding to support a leading healthcare organization. This individual will be responsible for coding complex professional fee services, including cardiovascular procedures, catheter-based interventions, diagnostic testing, and E&M services. The ideal candidate has extensive experience interpreting documentation, applying coding regulations, ensuring compliance, and serving as a subject matter expert for coding quality and accuracy.Responsibilities include reviewing and coding professional fee services for cardiology, cardiac surgery, thoracic surgery, vascular surgery, catheter-based procedures, diagnostic testing, and Evaluation & Management (E&M) services. Accurately assign CPT, ICD-10-CM, HCPCS, and modifier coding in compliance with payer and regulatory guidelines. Analyze complex documentation and...

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.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...

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. 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...

Remote Chicago - 550 Van Buren Michigan-Grayling Pennsylvania-Trappe Boro Pennsylvania-East Lampeter Twp Pennsylvania-Skippack Twp Pennsylvania-Bethel Twp (Armstrong) Pennsylvania-North Bethlehem Twp Pennsylvania-South Park Twp Pennsylvania-West Norriton Twp Pennsylvania-West Mifflin Boro Pennsylvania-Wilkinsburg Boro Pennsylvania-Cogan House Twp (Lycoming) Kentucky-Wolfe County Pennsylvania-Reading (Berks) Pennsylvania-Bensalem Twp Pennsylvania-Lower Salford Twp Ohio-Mentor Michigan-Lansing Pennsylvania-Clarks Green Boro Ohio-Lima Pennsylvania-Bethlehem Twp Pennsylvania-West Cornwall Twp (Lebanon) Pennsylvania-Edgeworth Boro Ohio-Rocky River Kentucky-Murray Pennsylvania-Kennedy Twp Pennsylvania-Moon Twp Ohio-Bay Village Ohio-Lakewood Ohio-Ashville Kentucky-Lakeside Park Pennsylvania-Lower Paxton Twp Ohio-Oxford Ohio-Bedford Pennsylvania-Ross Twp Pennsylvania-Newtown Twp Pennsylvania-Washington Twp...

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...

City / StateNorfolk, VAWork ShiftFirst (Days)Overview :Claims Resolution Coder- RemoteResponsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE),or other third party payer specific claims processing guidelines.Works with Coding, Billing and Reimbursement staff to resolve edits.Is additionally responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing.Researches regulations to ensure accuracy of CPT codes and documentation.Associates degree in Health Information Technology or Medical Billing preferred.2 years direct application of coding, medical billing or reimbursement in health care setting, hospital or physician office required.CPC or CCS coding certification required at time of hire.Thorough knowledge of lab,...