79 professional services coder jobs found

Newport News, Virginia Hiring Range $27.30 - $37.58/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 The Inpatient Coder II is responsible for analyzing the medical record to assign International Classification of Diseases (ICD) Clinical Modification (CM) diagnoses and Procedure Coding System (PCS) procedure codes to ensure correct code assignment and optimal reimbursement in compliance with state and federal guidelines. Works in collaboration with the Clinical Documentation Improvement (CDI) team to ensure accurate Diagnosis Related Group (DRG) assignment and works closely with management to resolve problems and meet...

Riverside Health System is seeking an Inpatient Coder II to analyze medical records, assign ICD-10-CM/PCS codes, and optimize DRG accuracy for proper reimbursement. You will collaborate with the CDI team to resolve coding issues and ensure timely throughput. The role requires strong knowledge of medical terminology, anatomy, and physiology, plus experience with EMR systems (EPIC preferred) and encoder software. Remote work eligibility applies for certain states. #J-18808-Ljbffr

Pathology Coder IIIRequired Skills & Experience Must Haves:5+ years of medical coding experienceCoder III level experiencePathology coding experienceExperience processing both PB and HB chargesEpic experience requiredStrong knowledge of CPT, ICD-10, HCPCS, and pathology coding guidelinesExperience coding anatomic pathology specimensCoding experience would include surgical specimens such as Bone Marrows, hysterectomies, organ resectionsJob Description:The Pathology Coder III is responsible for reviewing pathology documentation and assigning accurate ICD-10, CPT, and HCPCS codes for pathology and laboratory services. This individual will support both professional and hospital billing functions by ensuring coding accuracy, compliance, and appropriate charge capture. The ideal candidate has extensive pathology coding experience and a strong understanding of coding regulations, reimbursement methodologies, and documentation requirements.Note: UVA Health is seeking an experienced...

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...

## 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,...

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...

Job Description Job Description Medical Temporaries, Inc. is currently seeking an experienced ***Medical Biller/ Coder***. Minimum of 1+ years experience required  Medical Temporaries is looking for an immediate temporary Medical Payment Posting Specialist with experience in EPIC (Financial) PB module. The ideal candidate will have experience accurately posting medical payments, adjustments, credits, and other financial transactions within a healthcare setting. This is a TEMPORARY position (estimated 4 weeks) requiring immediate availability Monday-Friday from 8am-5pm, located in Virginia Beach (23462). Responsibilities: A Day in the Life of a Medical Biller/Coder: As a Financial Entry Specialist, you will be responsible for accurate and timely posting of medical payments and financial transactions within healthcare billing systems. This role will support accurate patient account records, financial reporting, reconciliation, and overall revenue...

HIMS Coding AuditorApply: Remote: Warwick Medical & Professional Center - Newport News, Virginia: Full time: Posted Today: 2026-037744Newport News, VirginiaHiring 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...

Amazon One Medical Senior Health Revenue CycleAs a member of the Amazon One Medical Senior Health Revenue Cycle team, the Medical Coder I will be responsible for supporting Clinical and Revenue Cycle teams in reviewing the coding accuracy of claims. This role reports into the Manager I, Finance. As part of Amazon Health Services, you will find yourself working with exceptionally talented and dedicated people committed to driving financial improvement, scalability, and process excellence. To support our growth, this candidate must possess a strong passion for accountability, setting high standards, raising the bar, and driving results through constant focus on improving existing and future state operations, systems, and processes in collaboration with management.Key job responsibilities:Managing multiple coding related projects and ensuring deliverables are up to One Medical standards while being turned around in an acceptable time frameRemaining current on CPT, ICD-10-CM coding...

Job Description Job Description Description:   Charge Capture and Claim Submission Review and verify charges, CPT/ICD-10/HCPCS codes, and modifiers for orthopedic office visits, procedures, injections, imaging, DME, and surgical services before billing. Prepare, scrub, and submit clean claims to commercial, government, and third-party payers through athenaOne, resolving claim edits and clearinghouse rejections promptly. Track global surgical periods, bundling rules, and payer-specific requirements to ensure correct billing for orthopedic procedures. Denial Management and Appeals Work denials, rejections, kicked claims, and no-response claims daily in athenaOne; determine the kick reason and root cause, correct, and resubmit within payer timely-filing limits. Draft and submit appeals with supporting documentation, including for medical-necessity, authorization, coordination-of-benefits, and downcoding denials common in orthopedics. Route registration-driven denials...

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,...

Koniag Advisory Business Solutions, LLC (KABS) is seeking a Medical Records Technician – Coder III to support IHS Haskell Indian Health Center. This fully remote role requires accuracy and timely coding of outpatient encounters while maintaining coding currency and backlog reduction. The successful candidate will work independently in a remote environment, managing priorities and engaging with providers and staff to resolve documentation issues, with a focus on quality and productivity. #J-18808-Ljbffr

Department/Unit: Health Information Management Work Shift: Day (United States of America) Salary Range: $59,066.00 - $88,599.00 The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote. Essential Duties and Responsibilities Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes. Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Ensure established productivity and quality standards are met. Review denials, research and respond appropriately and timely....

## 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...

Washington D.C. Vienna, VA Tampa, FL Seattle, WA Phoenix, AZ Oakland, CA Nashville, TN Miami, FL Irvine, CA Houston, TX Fairfield, CT Denver, CO Dallas, TX Charlottesville, VA Orlando, FL Boston, MA Baltimore, MD USA Hamilton Full time R104665 Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care and life sciences disputes, compliance, and investigations. The team combines clinical, technical, operational, financial, economic, and analytic expertise to help clients and counsel resolve complex matters involving payers, providers, pharmacies, and law firms. Role Overview: The Senior Managing Director will be an executive-level, self-sustaining rainmaker who originates, sells, leads, and testifies in complex healthcare commercial disputes. The role requires a credible marketplace presence with health plans, law firms, and healthcare-focused...

focus on Encompass Hospital rehabilitation coding, which differs slightly from the typical PM&R coder. There will be wound care in addition to what you have below. They will be serving as a back up to all the items listed, so I think we could keep them, but a call out that the mainstay of the coding in Rehab Hospital coding. Accurate documentation and coding are essential to delivering high-quality patient care, supporting compliance, and ensuring the financial health of a leading academic medical center. This role offers an opportunity to make a meaningful impact by serving as a trusted coding quality resource for a highly specialized Physical Medicine & Rehabilitation practice. As a Coding Quality Specialist 3 supporting PM&R Musculoskeletal services, you will leverage your expertise in coding, auditing, and clinical documentation review to ensure accurate capture of complex services. This position will focus primarily on Encompass Hospital Rehabilitation...

Coding Educator/Auditor Insight Global is seeking a Coding Educator/Auditor for a healthcare system in Virginia. The educator will provide consulting services to physicians, residents, allied health professionals and billing staff to support patient care documentation, coding and billing practices according to federal, state and local regulatory compliance standards. • Creates and delivers presentations to clinical faculty and billing staff. • Develops training programs and delivers training and education sessions for physicians, allied health professionals, residents, and coding and billing staff to support compliance with third party documentation and billing regulatory standards, including but not limited to classroom training, web-based training and one-on-one provider observation and training sessions. • Participates on clinical department Billing Quality Councils as a member of the respective councils and acts as the primary resource providing technical and regulatory...

Pathology Coder III Required Skills & Experience Must Haves: 5+ years of medical coding experience Coder III level experience Pathology coding experience Experience processing both PB and HB charges Epic experience required Strong knowledge of CPT, ICD-10, HCPCS, and pathology coding guidelines Experience coding anatomic pathology specimens Coding experience would include surgical specimens such as Bone Marrows, hysterectomies, organ resections Job Description: The Pathology Coder III is responsible for reviewing pathology documentation and assigning accurate ICD-10, CPT, and HCPCS codes for pathology and laboratory services. This individual will support both professional and hospital billing functions by ensuring coding accuracy, compliance, and appropriate charge capture. The ideal candidate has extensive pathology coding experience and a strong understanding of coding regulations, reimbursement methodologies, and documentation requirements. Note: UVA Health is...

Job Description The Pathology Coder III is responsible for reviewing pathology documentation and assigning accurate ICD-10, CPT, and HCPCS codes for pathology and laboratory services. This individual will support both professional and hospital billing functions by ensuring coding accuracy, compliance, and appropriate charge capture. The ideal candidate has extensive pathology coding experience and a strong understanding of coding regulations, reimbursement methodologies, and documentation requirements. **Note: UVA Health is seeking an experienced Pathology Coder III to support newly acquired GI clinics that are currently operating within a manual coding workflow environment. This individual will work closely with pathology-related services while supporting both professional and hospital billing functions. The clinics are expected to transition fully to Epic within the next six months, making this a unique opportunity to participate in a system transformation initiative. Key...

Accurate coding is critical to the financial health, compliance, and operational success of a high-performing academic health system. This opportunity allows an experienced neurosurgery coding professional to contribute directly to revenue integrity, regulatory compliance, and the support of exceptional patient care through expert coding practices. As a fully remote Coding Specialist 3, you will serve as a subject matter expert in Gastrointestinal professional fee coding, independently reviewing complex clinical documentation and assigning accurate codes for surgical procedures, office-based services, and Evaluation & Management encounters. This role offers the opportunity to apply advanced coding expertise while partnering with providers and revenue cycle professionals to ensure coding accuracy, quality outcomes, and compliance. The Role In this highly specialized position, you will utilize your expertise in neurosurgery coding to accurately translate complex clinical...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. This position will support risk adjustment code validation for CMS and HHS Risk Adjustment models Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified...

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Medical Coder Job Location: Richmond, VA About the Role: We are seeking experienced Medical Coders to support post-market surveillance and adverse event case processing tied to FDA reporting requirements. This is a unique, high-priority role supporting consumer products, including nicotine and tobacco products. You will work directly within our existing complaint database-not a contractor-managed system-to ensure timely continuity of daily operational workflows. Key Responsibilities: Perform MedDRA coding on adverse event reports derived from consumer complaints. Conduct seriousness, severity, and expectedness assessments for each case. Identify potentially reportable serious adverse events in compliance with FDA requirements. Process daily consumer complaints within...

Posting Details Posting Summary Working Title Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Role Title Role Code FLSA Exempt Pay Band UG Position Number 295A0003 Agency Tidewater Community College Division Tidewater Community College (Div) Work Location Suffolk - 800 Hiring Range $30-$100 per hour, commensurate with qualifications and experience. Emergency/Essential Personnel No EEO Category I-Faculty Full Time or Part Time Part Time Does this position have telework options? -Telework options are subject to change based on business needs- No Does this position have a bilingual or multilingual skill requirement or preference? Work Schedule Varies Sensitive Position No Job Description Tidewater Community College has served South Hampton Roads - both students and employers - for 50 years. It has grown from 1 campus into a regional educational and...

Become a part of our caring community Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and...