22 outpatient complex coder jobs found

Job Title 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...

Job TitleNewport News, VirginiaHiring Range: $23.00 - $29.90/HourlyActual 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...

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. Newport News, Virginia 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 TitleEnsures 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 opportunities and queries clinical staff to fill in any gaps to clarify confusing, incomplete or conflicting information and obtain any needed additional documentation. Contacts and works with physicians as needed for clarification of details to ensure correct coding.Accurately utilizes the ICD-10-CM classification system and CPT...

## Compliance Coding AuditorApplyremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted Yesterdayjob requisition id: JR-104491**City/State**Norfolk, VA**Work Shift**First (Days)**Overview:**# Compliance Coding AuditorPerforms 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...

Compliance Coding AuditorPerforms 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 one year.All queries arising from the audit process are managed...

Location: This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG...

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...

*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...

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a work-from-home Inpatient Coding Auditor with Parallon you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies and the Company coding policies for complete, accurate and consistent coding which result in appropriate reimbursement and data integrity. You will review outcomes and communicate them to the HSC team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in coding practices and to improve the quality of physician documentation within the medical record to support code assignments. What you will do in this role Leads, coordinates and performs all functions of quality reviews (routine, pre-bill, policy driven and incentive plan driven) for inpatient and/or outpatient coding...

**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 and...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Job Title Risk Coder Location Virginia Beach, VA Work Shift First (Days) Job Description 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...

Job TitleMatch InsightsJob DescriptionDutiesAnalyze 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 appropriately identified.Assure secondary diagnoses are sequenced properly to assure maximum allocation under the Relative Value Unit (RVU) and Diagnosis-Related Group (DRG) systems.Provide review and analysis of coding accuracy and compliance statistics, coordinating results with the Coding Manager and Patient Administration Department Head for feedback to the providers.Prepare reports of findings and...

## 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,...

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:OverviewThe Medical Coding Specialist II is responsible for performing accurate and compliant coding activities while supporting revenue cycle operations across multiple specialties. This role requires a comprehensive understanding of the entire billing cycle, including medical terminology, coding principles, charge entry, insurance adjudication, contractual agreements, payment posting, statements, and collections. The ideal candidate demonstrates strong analytical skills, coding accuracy, and attention to detail while ensuring compliance with regulatory guidelines and organizational standards. This role collaborates closely with providers, clinical teams, and revenue cycle partners to support operational excellence, optimize reimbursement, and maintain coding integrity across healthcare services.EducationHigh School Diploma or Equivalent (Required)Certification/LicensureCertified Professional Coder (CPC) or Certified...

Medical Coding Specialist II Location: Virginia Beach, VA Work Shift: First (Days) Overview: The Medical Coding Specialist II is responsible for performing accurate and compliant coding activities while supporting revenue cycle operations across multiple specialties. This role requires a comprehensive understanding of the entire billing cycle, including medical terminology, coding principles, charge entry, insurance adjudication, contractual agreements, payment posting, statements, and collections. The ideal candidate demonstrates strong analytical skills, coding accuracy, and attention to detail while ensuring compliance with regulatory guidelines and organizational standards. This role collaborates closely with providers, clinical teams, and revenue cycle partners to support operational excellence, optimize reimbursement, and maintain coding integrity across healthcare services. Education: High School Diploma or Equivalent (Required) Certification/Licensure:...

Inova Health is looking for a dedicated Medical Records Coder 2 to join the HB 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...

The full-time Outpatient Medical Coder is responsible for performing remote coding on all outpatient visits and surgical procedures by the Veteran Affairs Health Care System (VAHCS). The medical coder will access the Veteran Affairs VistA/CPRS system to read and code medical records identified by the Veteran Affairs and enter codes into the approved encoder or other package. The Medical Coder is required to comply with all HIPAA provisions for a Business Associate, and all provisions in this Performance Work Statement. This is a full-time position supporting a VA medical coding program. Candidates must be available to work a consistent Monday-Friday schedule from 7:30 AM to 4:00 PM CST and be able to commit to full-time hours. This is a Full-Time Outpatient Medical Coding position that is classified as an SCA role which means an hourly rate + $5.55 per hour for Health and Welfare Benefits.

## 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...

Job Description Job Description Description: Vital Health and Integrative Care is seeking an experienced Medical Biller and Medical Coder to join our growing outpatient psychiatry practice. This is an in-office position responsible for managing the complete medical billing cycle, insurance claims, coding accuracy, payment posting, denial management, and insurance follow-up. The ideal candidate has experience billing for psychiatry and behavioral health services and is knowledgeable in CPT, ICD-10, and payer requirements. Requirements: Minimum of 2 years of medical billing and coding experience in a physician's office or outpatient setting. At least 1 year of psychiatry or behavioral health billing experience required. Knowledge of CPT, ICD-10-CM, and HCPCS coding. Experience with commercial insurance, Medicare, Medicaid, and Tricare claims. Proficient in the complete revenue cycle , including charge entry, claims submission, payment posting, denial management,...

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,...