25 outpatient complex coder jobs found

Capital Area Health Network (CAHN)Richmond, VA — On‑Site PositionMake 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 ValuesCompassion – 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 organization and community.Who We AreCAHN...

The Clinical Coding Coordinator (Lead Coder) provides advanced coding expertise to ensure the accuracy, integrity, and completeness of coded data across hospital services. The coordinator performs pre-bill and retrospective validation reviews, resolves complex coding issues, and serves as a resource to coding, CDI, and related teams to ensure adherence to official coding guidelines and documentation standards. This role focuses on complex case review, quality oversight, and ensuring the integrity of coded data submitted for reimbursement, quality reporting, and value-based payment models. Performs pre-bill and retrospective reviews to validate the accuracy of diagnosis and procedure coding, sequencing, and DRG or APC assignment. Identifies and resolves coding issues that delay account completion and ensures documentation supports accurate capture of severity of illness and risk of mortality. Reviews and validates coding impacting comorbidities, patient safety...

Monday - Friday 8 AM to 4:30 PM GENERAL SUMMARY Under general supervision, the Hospital Medical Coder II is responsible for the collection of relevant, pertinent, accurate and timely profile data configured and/or abstracted from the hospital's outpatient, observation, day surgery, urgent care and emergency records moving from the least complex to the most complex. This position maybe responsible for coding inpatient records as needed/requested by management; this includes effective use of relevant coding systems as well as recognizing what data can be abstracted, presented and interpreted for effective use throughout the hospital network. Reports to department management. ESSENTIAL DUTIES AND RESPONSIBILITIES Uses established coding guidelines to ensure the most effective and accurate coded profile on the patient. Abstracts pertinent and accurate data from the clinical record. Works with hospital and clinical staff to ensure that accurate and relevant patient data is...

The Children’s Hospital Of The King’s Daughters is seeking a Hospital Medical Coder II to accurately abstract and code data from outpatient, observation, day surgery, urgent care and emergency records, progressing from less complex to more complex cases. Under supervision, you will use ICD, DRGs, CPT/HCPCS and outpatient groupers, with collaboration from clinical staff to ensure data supports reimbursement and statistical reporting. RHIT/CPCH/CCS certifications are preferred. #J-18808-Ljbffr

Location: Fairfax, Virginia, United StatesCompany: AAPCPosted: Job DescriptionSince 1984, Fairfax Colon & Rectal Surgical Center (FCRS) has evolved into the largest single specialty group of colorectal surgeons in the Northern Virginia/DC Metro region. We have accomplished this by serving our patients, employees, and healthcare community with integrity, leadership, and commitment to excellence. Our mission is to provide the highest quality, innovative, coordinated colorectal care for all of our patients.We are looking to add an additional Certified Professional Coder to our billing team: The Certified Professional Coder at Fairfax Colon & Rectal Surgery plays a critical role in ensuring accurate and compliant medical coding for surgical procedures. This position is responsible for translating complex surgical documentation into standardized codes used for billing, reimbursement, and statistical analysis. The coder must maintain up-to-date knowledge of coding guidelines,...

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...

About the role As a Emergency Deparment Coder, you will make an impact by ensuring the accuracy, quality, and compliance of medical coding practices across multiple healthcare settings. You will be a valued member of the Health Information Management team and work collaboratively with coding professionals, physicians, and operational stakeholders to support regulatory compliance and revenue cycle excellence. In this role, you will: Review clinical documentation and accurately assign diagnosis and procedure codes for outpatient surgery, observation, emergency department, and outpatient diagnostic encounters. Communicate with physicians and clinical staff to obtain clarification on diagnoses and procedures through the coding query process. Utilize electronic encoder applications and coding tools to assign accurate codes in accordance with company policies and regulatory guidelines. Perform peer reviews and quality audits of coding professionals to ensure coding accuracy,...

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 Medical Coder (CCS certified) Assignment Details: 100% REMOTE Position Type: W2 Regular Employment At least 5 years of IP PCS Coding experience, required At least 3 years OP, preferred CCS certificate is required. Schedule: Weekdays, full-time hours Shift: Regular day shift hours System Experience: Cerner | Power Chart | 3M | EPIC Start Date: Immediately To be considered, IP and/or OP assessment test will be required to complete and pass a coding assessment test. Summary IP/OP Coding Specialist demonstrates proficiency in coding all types of inpatient and outpatient accounts. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Responsibilities: 1. Examines the complete medical record to accurately determine the principal & secondary diagnoses, procedures, and...

## 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 patients...

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...

UKG is seeking a Senior Coding Specialist to accurately assign and sequence ICD-10-CM/PCS and CPT-4/HCPCS codes for inpatient and outpatient records in Virginia. The role requires meticulous attention to documentation, adherence to coding guidelines, and collaboration with clinical staff to obtain complete records. Responsibilities include selecting DRG and APC, abstracting data, entering information into coding systems, and ensuring compliance with accuracy targets. #J-18808-Ljbffr

## 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,...

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,...

Medical Records Technician Coder IIIKoniag Advisory Business Solutions, LLC a Koniag Government Services company, is seeking a Medical Records Technician Coder III to support KABS and our government customer. The position is remote. This position requires the candidate to be able to obtain a Public Trust.This position is covered under the Service Contract Act. Benefits include medical, dental, and vision insurance, 401(k) retirement plan, paid time off, paid parental leave, life and disability insurance, flexible spending accounts, commuter benefits, and tuition reimbursement.Koniag Advisory Business Solutions (KABS) is seeking an experienced Medical Records Technician – Coder III to support the Indian Health Service (IHS) Haskell Indian Health Center. This is a fully remote position responsible for accurate and timely coding of outpatient and ambulatory patient encounters and supporting the facility's efforts to reduce its existing coding backlog and maintain coding currency.The...

Coding SpecialistNewport News, VirginiaHiring Range $28.90 - $39.78/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 Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated.What you will doEnsures coding compliance. Applies all coding guidelines and principles as defined in the Coding Clinic and leading authorities. Complies with standardized coding standards, conventions and regulations, corporate compliance standards and reimbursement...

Applications for this position will be accepting through November 22, 2026. This position may be filled prior to the posted deadline. Interested candidates are encouraged to apply as soon as possible. Koniag Advisory Business Solutions, LLC a Koniag Government Services company, is seeking a Medical Records Technician Coder III to support KABS and our government customer. The position is remote. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. Benefits include medical, dental, and vision insurance, 401(k) retirement plan, paid time off, paid parental leave, life and disability insurance, flexible spending accounts, commuter benefits and tuition reimbursement. Koniag Advisory Business Solutions (KABS) is seeking an experienced Medical Records Technician – Coder III to support the Indian Health Service (IHS) Haskell Indian Health Center. This is a fully remote position responsible for accurate and timely...

Inpatient Medical Coder (CCS certified) Assignment Details: 100% REMOTE Position Type: W2 Regular Employment At least 5 years of IP PCS Coding experience, required At least 3 years OP, preferred CCS certificate is required. Schedule: Weekdays, full-time hours Shift: Regular day shift hours System Experience: Cerner | Power Chart | 3M | EPIC Start Date: Immediately To be considered, IP and/or OP assessment test will be required to complete and pass a coding assessment test. Summary : IP/OP Coding Specialist demonstrates proficiency in coding all types of inpatient and outpatient accounts. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Responsibilities: 1. Examines the complete medical record to accurately determine the principal & secondary...

Inpatient Medical Coder (CCS certified) Assignment Details: 100% REMOTE Position Type: W2 Regular Employment At least 5 years of IP PCS Coding experience, required At least 3 years OP, preferred CCS certificate is required. Schedule: Weekdays, full-time hours Shift: Regular day shift hours System Experience: Cerner | Power Chart | 3M | EPIC Start Date: Immediately To be considered, IP and/or OP assessment test will be required to complete and pass a coding assessment test. Summary : IP/OP Coding Specialist demonstrates proficiency in coding all types of inpatient and outpatient accounts. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Responsibilities: 1. Examines the complete medical record to accurately determine the principal & secondary...

Inpatient Medical Coder (CCS certified) Assignment Details: 100% REMOTE Position Type: W2 Regular Employment At least 5 years of IP PCS Coding experience, required At least 3 years OP, preferred CCS certificate is required. Schedule: Weekdays, full-time hours Shift: Regular day shift hours System Experience: Cerner | Power Chart | 3M | EPIC Start Date: Immediately To be considered, IP and/or OP assessment test will be required to complete and pass a coding assessment test. Summary : IP/OP Coding Specialist demonstrates proficiency in coding all types of inpatient and outpatient accounts. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Responsibilities: 1. Examines the complete medical record to accurately determine the principal & secondary...

Inpatient Medical Coder (CCS certified) Assignment Details: 100% REMOTE Position Type: W2 Regular Employment At least 5 years of IP PCS Coding experience, required At least 3 years OP, preferred CCS certificate is required. Schedule: Weekdays, full-time hours Shift: Regular day shift hours System Experience: Cerner | Power Chart | 3M | EPIC Start Date: Immediately To be considered, IP and/or OP assessment test will be required to complete and pass a coding assessment test. Summary : IP/OP Coding Specialist demonstrates proficiency in coding all types of inpatient and outpatient accounts. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Responsibilities: 1. Examines the complete medical record to accurately determine the principal & secondary...

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 implementing these updates in...

Certified IRC CoderInova 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: 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...

## HIMS Coding AuditorApply: Remote: Warwick Medical & Professional Center - Newport News, Virginia: Full time: Posted Today: 2026-037744Newport News, Virginia**Hiring Range**$28.90 - $39.78/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 AHIMA ID or CREDENTIAL 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** Responsible for maintaining coded data quality through ongoing quality review and assessment of outpatient or inpatient records. Performs audits on accuracy of APC or MSDRGs as well as on quality of medical record documentation needed for accurate coding. Works with DRG and CPT denials from commercial payers and writes appeal letters as indicated. **What you will do*** Ensures coding...