110 professional coder jobs found

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...

Datavant is seeking a Profee Auditing Specialist to conduct coding audits and ensure compliance within the healthcare sector. This fully remote position requires 5+ years of experience in Professional Fee coding, with a strong emphasis on customer service and leadership skills. The ideal candidate will have a CPC certification and experience with software such as Epic and Cerner, contributing to healthcare data solutions that improve health outcomes. #J-18808-Ljbffr

eBanqo Inc in Norfolk, Virginia is seeking a skilled Medical Coder. The role involves coding and billing duties, ensuring documentation supports medical necessity, and working with CPT and ICD 10 codes. Candidates must have prior coding experience and current CPC certification, or be willing to obtain it within a year. The position requires proficiency in medical applications, specifically Allscripts/IDX, and a strong understanding of reimbursement processes. Competitive salary and benefits available. #J-18808-Ljbffr

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 one year. All queries arising from the audit process are...

Childrens Hospital of The Kings Daughters is seeking a Hospital Medical Coder II in Norfolk, Virginia. This role involves accurate coding of outpatient and inpatient records, requiring certifications like RHIT, CPCH, or CCS. Ideal candidates have at least one year of outpatient coding experience and knowledge of ICD and CPT coding systems. The position offers a traditional work schedule from Monday to Friday, ensuring work-life balance. #J-18808-Ljbffr

Coder Position The Atlantic Region CBO is seeking a dynamic and talented Coder. The Coder is responsible for reviewing medical records and assigning ICD-10-CM and CPT codes to Inpatient and/or Outpatient records. Key responsibilities include: posting charges and level emergency room visits, abstracting medical, demographic and other information from the medical record and entering data into the hospital wide information system, meeting coding standards and daily productivity, and other duties as assigned. Benefit highlights include a challenging and rewarding work environment, competitive compensation and generous paid time off, excellent medical, dental, vision and prescription drug plans, 401(k) with company match and discounted stock plan, SoFi student loan refinancing program, and career development opportunities within UHS and its 300+ subsidiaries. More information is available on our benefits guest website: benefits.uhsguest.com. Qualifications Job requirements include...

Job Description Job Description About Us: Dominion Women’s Health is dedicated to delivering high-quality healthcare services with accuracy, efficiency, and integrity. We are seeking a detail-oriented and knowledgeable Medical Coder to join our team on-site and play a critical role in ensuring proper coding and billing practices. As a part of our team, all employees must maintain strict confidentiality and adhere to all HIPAA and OSHA regulations to ensure patient privacy and workplace safety. Qualifications: Certified Professional Coder or Certified Professional Coder Apprentice 1–2 years of coding experience preferred (newly certified candidates may be considered). Strong knowledge of ICD-10, CPT, and HCPCS coding guidelines. Ability to work independently with strong attention to detail. Excellent communication and organizational skills. Must be willing to submit to a background investigation, including for example, verification of your past employment, criminal...

Inpatient Coder The Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. This position performs the primary function of coding inpatient or outpatient records to include Ambulatory, ER and Miscellaneous Ancillary charges. Utilizes 3M Encoder to code and classify inpatient and/or outpatient records according to ICD-10. Responsible and accountable for maintaining performance skills. Key responsibilities include: Coding of inpatient/outpatient medical records in accordance with AHA Coding/NCCI compliance guidelines. Review medical records online and assign ICD-10-CM and CPT codes to inpatient and/or outpatient records. Ability to code inpatient and outpatient hospital records with a 95% accuracy rate. Consistently meets productivity standards in accordance with HIM Departmental guidelines. Maintains a coding proficiency rating consistent with HIM Departmental standards. Compliance with continued educational requirements...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for...

Medical Coder Venesco is seeking a detail-oriented Medical Coder to support clinical trials through accurate coding and reconciliation of medical data. Remote/Hybrid Full-Time Key Responsibilities: Code medical terminology using MedDRA and WHO Drug dictionaries Ensure consistency and quality of coded clinical trial data Review case report forms (CRFs) for accuracy Maintain coding conventions and documentation Generate coding reports and support data reconciliation activities Minimum Qualifications: Bachelor's degree in life sciences or related field 35 years of medical coding experience Knowledge of MedDRA and WHO Drug coding systems Preferred Qualifications: Medical coding certification Experience supporting clinical trials

Inova Health System in Fairfax, VA is seeking a Medical Records Coder Supervisor to lead the inpatient coding team. This full-time position offers remote work flexibility and focuses on compliance analysis, trend reporting, and operational management. The ideal candidate should have at least 5 years of coding experience and hold necessary certifications. Benefits include health coverage, retirement matching, and education assistance, underscoring Inova's commitment to employee welfare. #J-18808-Ljbffr

Newport News, Virginia FOR APPLICATION REVIEW - PROVIDE YOUR CREDENTIAL OR AHIMA ID 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 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 policies. Identifies training needs and provides education to team members. May teach...

Coder The Atlantic Region CBO is seeking a dynamic and talented Coder. The Coder is responsible for reviewing medical records and assigning ICD-10-CM and CPT codes to Inpatient and/or Outpatient records. Key responsibilities include: posting charges and level emergency room visits, abstracting medical, demographic and other information from the medical record and entering data into hospital wide information system, meeting coding standards and daily productivity. Other duties as assigned. Benefit highlights include: challenging and rewarding work environment, competitive compensation & generous paid time off, excellent medical, dental, vision and prescription drug plans, 401(K) with company match and discounted stock plan, SoFi student loan refinancing program, and career development opportunities within UHS and its 300+ subsidiaries! Qualifications: high school diploma or equivalent, 2 years coding experience in ICD-10-CM and CPT-4. Computer/keyboard skills, knowledge of...

Certified Coder 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. The Atlantic Region CBO is seeking a dynamic and talented Certified Coder. The primary responsibility of the Coder is to assist the CBO with the review of medical records, assign ICD-10 and CPT codes to Inpatient or Outpatient records as needed, meet productivity requirements and meet all legal (federal and state) coding requirements. Key Responsibilities include: Analyze and evaluate medical records and assign appropriate ICD-10 and CPT diagnostic and/or procedure codes in accordance with coding guidelines. Reviews APC edits and add modifiers or delete charges as needed Consult with hospital staff when necessary to secure sufficient information to clarify data for proper coding and resolve discrepancies in the...

***To be considered for the role, you must permanently reside in one of the following states: Alabama, Arkansas, Florida, Georgia, Kentucky, Kansas, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia, or West Virginia*** The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors. The Senior Compliance Auditor supports the audit supervisor with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor performs documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility)...

Careers With Purpose Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. Job Summary Responsible for conducting internal audits and monitors to ensure that the organization’s processes and operations are in compliance with laws, corporate guidelines, best practices, and contractual agreements. Knowledgeable of general audit concepts and techniques, including the type of audits, the approaches and processes, and the subsequent activities as they relate to internal audits. Demonstrates the ability to interpret Federal rules and regulations. Demonstrates the ability to research regulation from various data sources. Demonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in Current...

A healthcare technology firm in the United States seeks a Medical Coder II or III to enhance coding quality and efficiency. The role involves reviewing model-generated codes, collaborating with cross-functional teams, and ensuring adherence to guidelines. Ideal candidates have a solid background in medical coding, strong communication skills, and a commitment to professional development. This position offers competitive benefits and an engaging work environment focused on innovation and patient care. J-18808-Ljbffr

Who You Are You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role As a Lead CDI Coder you are responsible for partnering with physician offices within our established partnerships to assist in translating healthcare documentation into standardized codes, ensuring accurate coding and billing of patient encounters, as supported by the medical record. You serve as a subject matter expert in Coding and Documentation. Role...

Job Summary Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders translate diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Responsibilities Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses, and procedures performed that explain the reason for service being provided or the admission and patient severity and complies with standard...

Geisinger is seeking skilled health information coders to transform medical records into coded form for reimbursements. Responsibilities include reviewing records, coding diagnoses and procedures, and communicating with healthcare providers for accuracy. Ideal candidates will possess a high school diploma, relevant certification, and at least one year of experience in coding. Benefits include health, vision, and dental coverage from the start. #J-18808-Ljbffr

We’re hiring a Lead Inpatient Coder to support and oversee a team of 11 coders in a high-priority growth environment. If you’re a seasoned inpatient coder ready to step into a leadership-focused role — this is your opportunity. What You’ll Do Review accounts after coders to ensure accuracy and compliance Work claimedics edits and respond to escalations Support coding questions from internal staff and provider offices Provide oversight and guidance to a team of 11 coders Ensure coding compliance, reimbursement accuracy, and timely billing Stay current on ICD-10-CM guidelines and federal/state reimbursement regulations This role is highly visible and critical to maintaining coding quality and revenue integrity. What We’re Looking For 5–8+ years of inpatient facility and/or pro-fee coding experience Expert-level ICD-10-CM diagnostic & procedure coding knowledge CPC, CCS, and/or CCS-P certification required Strong understanding of coding compliance...

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Were focused on improving the health of our members, enhancing our operational effectiveness and reinforcing our reputation for high-quality health services. As Senior Inpatient Medical Coder you will provide coding services directly to providers. Youll play a key part in healing the health system by ensuring our high standards for documentation processes...

Position Summary Codes accurately and productively with abstraction to assigned inpatient medical records to meet the reimbursement, indexing, and statistical requirements of the hospital. Consistently maintains production and accuracy standards at all times. Essential Duties and Responsibilities Accurately code and sequence all diagnoses and procedures documented in the medical record according to the established official coding guidelines, principles, and appropriate reimbursement standards. Utilizes Computer Assisted Coding software program following assigned workflows. Accurately abstracts required data entering into Computer Assisted Coding system. Works with Clinical Documentation Improvement Specialists to assure clear, concise, and specific documentation from physicians when clarification is needed. Issues accurate coding queries following AHIMA compliant coding query guidelines and assists medical staff member documentation clarification. Ability to meet and...