36 provider coding auditor educator jobs found

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coder Full Time MED-Conforming JB Langley-Eustis, Ft. Eustis, VA, US 1 Attachments 5 days ago Requisition ID: 1063 Salary Range: $35.06 To $40.15 Hourly About Company: Since 1984, Professional Performance Development Group (PPDG) has been proudly Serving Heroes by connecting exceptional healthcare professionals with rewarding opportunities across military, federal, and commercial healthcare facilities. Guided by our core principles of excellence, integrity, andcollaboration , we are dedicated to delivering high-quality staffing solutions that strengthen the delivery of patient care nationwide. Rooted in a culture of Linked Prosperity , PPDG values the success of our clients, employees, and partners alike—offering competitive compensation, comprehensive benefits, professional growth, and a cooperative...

Exceptional inpatient coding quality has a direct impact on patient care, reimbursement integrity, research initiatives, and the accuracy of healthcare data. This leadership-oriented coding opportunity allows an experienced inpatient coding professional to serve as a trusted expert, mentor, and quality champion within one of the nation's leading academic health systems. If you've progressed beyond production coding and enjoy auditing, education, solving complex coding challenges, and helping others succeed, this role offers the opportunity to make a meaningful impact while working with highly specialized cases and some of the most advanced programs in healthcare. The Role As the Clinical Coding Coordinator (Lead Coder) for Hospital Inpatient Coding, you will serve as the team's primary subject matter expert and quality resource. This is not a traditional production coding role. Instead, you will be the expert consultants turn to when complex questions arise, helping ensure...

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...

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...

Become a part of our caring community The Inpatient Medical Coding Auditor 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. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to...

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...

## 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,...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor)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 economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of whom pursued degrees that would let them transfer to 4-year institutions. Of South Hampton Roads residents enrolled in higher education 33% enrolled at TCC. TCC's institutional accreditation is affirmed through 2027 by the Southern Association of Colleges and Schools...

Title: Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor) Agency: Tidewater Community College Location: Suffolk - 800 FLSA: Exempt Hiring Range: $30-$100 per hour, commensurate with qualifications and experience. Full Time or Part Time: Part Time Additional Detail 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 economic force. TCC is the largest provider of higher education and workforce services in Hampton Roads, enrolling nearly 25,000 students in 2024-25. Founded in 1968 as a part of the Virginia Community College System, Tidewater Community College (TCC) services South Hampton Roads with 4 campuses in Chesapeake, Norfolk, Portsmouth, and Virginia Beach, 7 regional centers and 2 important cultural institutions. The college had 3,399 graduates in 2024-2025, 40 percent of...

This is a remote based position. Applicants can be located nationwide Outpatient Coding Auditor #2972 United States Remote/Nationwide Position Description About You You are a person who enjoys ensuring coding accuracy and solving documentation and compliance challenges. We need someone who demonstrates skills in organization, prioritization, professionalism, and coaching others. In the role of Outpatient Coding Auditor, you will be responsible for quality reviews and audits and coordinating with department managers to ensure standards are met in accordance with department and organization policies. Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM), Procedural Coding System (PCS), Current Procedural Terminology (CPT-4 and Healthcare Common Procedure Coding System...

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...

Required Skills & Experience Certified coder (CPC, CCS, CRC, CCA, or equivalent certification) Strong ICD-10-CM coding experience and medical record review background Knowledge of Risk Adjustment and HCC coding methodologies Experience reviewing physician documentation and assigning accurate diagnosis codes Strong understanding of medical terminology, anatomy, physiology, and disease processes Ability to interpret complex clinical documentation with high accuracy and productivity Familiarity with CMS guidelines and Medicare Advantage requirements Nice to Have Skills & Experience Medicare Advantage Risk Adjustment experience Experience working with CMS-HCC models CRC (Certified Risk Adjustment Coder) certification Experience with EMRs and coding software platforms Background in a health plan, physician practice, hospital, or revenue cycle environment Audit and quality assurance experience Job Description Insight Global is seeking Medical Coders specializing in Risk...

Exceptional inpatient coding quality has a direct impact on patient care, reimbursement integrity, research initiatives, and the accuracy of healthcare data. This leadership-oriented coding opportunity allows an experienced inpatient coding professional to serve as a trusted expert, mentor, and quality champion within one of the nation's leading academic health systems. The Role As the Clinical Coding Coordinator (Lead Coder) for Hospital Inpatient Coding, you will serve as the team's primary subject matter expert and quality resource. This is not a traditional production coding role. Instead, you will be the expert consultants turn to when complex questions arise, helping ensure the highest standards of coding accuracy, compliance, and reporting integrity. In this completely remote role you’ll work closely with coding professionals across the organization, providing guidance, education, quality oversight, and support for highly complex inpatient cases. Your expertise will...

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : A mix of inpatient community and academic coding. Includes service lines such as cardiology, neurology, and oncology. Schedule : Full-time, Monday-Friday 40hrs with a standard schedule of Monday through Friday, 8 hours per day, totaling 40 hours each week. Certification required : Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $33.05 - $49.60...

POSITION SUMMARY Conducts reviews and provides recommended corrections of billed services as it relates to clinical documentation for the VMG enterprise. Assists in the reviews and responses to payor and governmental audits of billed services. Assists the CBO in replying to payor denials and patient inquiries as it relates to services billed. Reviews and research new coding guidelines and codes. Assists the staff of the VHS corporate compliance. EDUCATION CPC (AAPC) required. Degree in Heath Services Management, Business or another related field preferred. Extensive knowledge of ICD-9-CM/ICD-10 CM and CPT coding principles and guidelines required. Extensive knowledge of reimbursement systems required. EXPERIENCE Eight to ten years’ experience (college degree can be substituted for years of experience) and expertise in ICD-9 CM/ICD-10 CM Coding. SPECIAL SKILLS Medical Terminology, ICD-9 CM/ICD-10 CM and CPT-4 Coding, Ability to relate to people and work closely with physicians...

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...

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...

Department: 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Will support : A mix of inpatient community and academic coding. Includes service lines such as cardiology, neurology, and oncology. Schedule : Full-time, Monday-Friday 40hrs with a standard schedule of Monday through Friday, 8 hours per day, totaling 40 hours each week. Certification required : Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity: Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range: $33.05 - $49.60 Major...

Psychiatry Professional Fee Coder High School Diploma or GED required. Certified Professional Coder (CPC), Certified Coding Specialist – Physician-based (CCS-P), or equivalent coding certification required. Minimum 3 years of professional fee coding experience. Minimum 2 years of Psychiatry or Behavioral Health coding experience. Strong understanding of: Psychiatric Diagnostic Evaluation Codes (90791, 90792) Psychotherapy Codes (90832, 90834, 90837) Add-on Psychotherapy Codes Evaluation & Management (E/M) Services Telehealth Behavioral Health Coding ICD-10 Mental Health Diagnostic Coding Experience reviewing provider documentation within an EHR system. We are seeking an experienced Psychiatry Professional Fee (ProFee) Coder to join our Revenue Cycle team. This individual will be responsible for accurately assigning ICD-10-CM, CPT, HCPCS, and modifier codes for psychiatric and behavioral health services. The coder will review provider documentation, ensure coding compliance,...

Compliance AuditorThe Compliance Auditor plans, schedules, and performs comprehensive internal professional fee audits to include routine audits, focused audits, for cause audits and, not for cause audits for Chesapeake Regional Healthcare (CRH) and all of its affiliated entities. Performs detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure corrective action and/or appropriate response to identified issues. Communicates audit results to providers, coders, management, and other appropriate staff. Develops and delivers provider and coder education. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional fee documentation, coding, and billing. Stays abreast of documentation, coding, and billing regulations and standards and serves as a subject matter expert on the interpretation and application of...

Health Careers- Workforce Development Non-Credit Instructor- Adjunct (Medical Coder/Auditor)Tidewater Community College's Workforce Solutions Department seeks an experienced Medical Coder/Auditor to lead a hands-on Certified Professional Medical Auditor (CPMA) exam–preparation course. This position is an adjunct instructor position in the college's non-credit program under Workforce Solutions. This program includes both continuing education for professional development and industry recognized credential attainment, which may be offered Asynchronously, at TCC campuses and other convenient locations throughout the community. The CPMA instructor will prepare students to audit medical records and ensure coding accuracy and compliance. Emphasis is placed on healthcare regulations, documentation review, and revenue integrity. The candidate will deliver engaging CPMA-focused instruction using real-world coding scenarios, chart reviews, and denial analysis.The instructor must be...

DRG Coding Auditor - MS-DRG and APR-DRGSign On Bonus: $1,500Virtual: This role enables associates to work virtually full-time, with the exception of 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 an accommodation is granted as required by law.The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation...

City/State Norfolk, VA Work Shift Multiple shifts available 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...