29 cpc certified professional coder jobs found in Charlottesville, VA

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 claims...

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...

Clinical Coding Coordinator (Lead Coder) - Hospital Outpatient 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...

Your expertise in inpatient coding does more than support reimbursement. It drives clinical accuracy, quality reporting, regulatory compliance, and data integrity across a leading academic health system. This is an opportunity to apply advanced coding knowledge in a highly specialized environment while enjoying the flexibility of a fully remote role. As a Senior Hospital Inpatient Coder, you will review and code some of the most complex inpatient encounters in academic medicine, including trauma, transplant, critical care, and advanced medical and surgical cases. This role is ideal for experienced inpatient facility coders who thrive in a high-acuity environment, value autonomy, and are committed to coding excellence. The Role In this highly independent position, you will serve as a trusted coding expert responsible for the accurate assignment of inpatient facility codes and classification systems that support quality outcomes, compliance, and organizational performance....

Clinical Coding Coordinator (Lead Coder) - Hospital Outpatient Coding Hospital outpatient coding requires expertise across a wide range of services, specialties, and reimbursement methodologies. This opportunity is ideal for an experienced outpatient coding professional who enjoys solving complex coding challenges, auditing for quality, researching regulatory guidance, and serving as a trusted resource for others. If you've progressed beyond production coding and enjoy education, mentoring, and helping coders navigate difficult coding scenarios, this role offers the opportunity to apply your expertise across a diverse outpatient environment that includes emergency department services, observation, same-day surgery, interventional radiology, cardiac catheterization, infusion services, and other hospital-based outpatient care. The Role As the Clinical Coding Coordinator (Lead Coder) for Hospital Outpatient Coding, you will serve as a senior coding resource and subject...

Job Description Insight Global is seeking an OB/GYN Professional Fee Coder for a top healthcare client supporting a high-volume academic medical center and Level I Trauma environment. This candidate will handle complex professional-fee coding across a diverse OB/GYN service line, including office visits, surgical procedures, and deliveries. The coder will work with documentation from physicians, residents, and midwives while accurately assigning CPT, ICD-10-CM, and modifiers to support compliant reimbursement. This is an excellent opportunity for an experienced OB/GYN coder looking to work with complex cases spanning MFM, urogynecology, and other specialized services. Day-to-Day: • Perform professional-fee coding across OB/GYN, MFM, urogynecology, and related specialty services • Code clinic visits, surgical procedures, and deliveries • Assign accurate CPT, ICD-10-CM, and modifier coding based on provider documentation • Review documentation from physicians, residents, and...

GI Coder IIIRequired Skills & Experience Must Haves: • 5+ years of professional medical coding experience • Coder III level experience • Extensive GI coding experience • Experience coding: • Colonoscopies • EGDs (Esophagogastroduodenoscopy procedures) • Other GI surgical procedures • Experience in: • Endoscopy Suites • Ambulatory Surgery Centers (ASCs) • EPIC experience required • Experience with coding encoders such as: • Codify • Encoder Pro • Experience using ProVationNice to Have Skills & Experience Nice to Haves: • Academic medical center experience • Experience supporting system conversions or EMR transitionsJob Description The GI Coder III is responsible for reviewing and assigning accurate ICD-10, CPT, and HCPCS codes for a variety of gastroenterology procedures and services. This individual will analyze physician documentation, operative reports, endoscopy reports, and related medical records to ensure coding accuracy, compliance, and appropriate reimbursement. The...

University of Virginia Health is seeking a Lead Inpatient Coder in a fully remote role to serve as the team’s subject matter expert for complex inpatient coding questions, audits, and quality oversight. You will educate and mentor other coders, ensure accuracy, and support reimbursement integrity across the organization. This leadership-focused position works on highly complex cases within UVA Health, a premier academic medical center, emphasizing collaboration, education, and continuous process #J-18808-Ljbffr

Coding Quality Specialist 3 - PM&R CoderFocus 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...

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 RoleAs 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...

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...

OB/GYN Professional Fee Coder Insight Global is seeking an OB/GYN Professional Fee Coder for a top healthcare client supporting a high-volume academic medical center and Level I Trauma environment. This candidate will handle complex professional-fee coding across a diverse OB/GYN service line, including office visits, surgical procedures, and deliveries. The coder will work with documentation from physicians, residents, and midwives while accurately assigning CPT, ICD-10-CM, and modifiers to support compliant reimbursement. This is an excellent opportunity for an experienced OB/GYN coder looking to work with complex cases spanning MFM, urogynecology, and other specialized services. Day-to-Day: Perform professional-fee coding across OB/GYN, MFM, urogynecology, and related specialty services Code clinic visits, surgical procedures, and deliveries Assign accurate CPT, ICD-10-CM, and modifier coding based on provider documentation Review documentation from physicians,...

Insight Global is seeking an OB/GYN Professional Fee Coder for a top healthcare client at a high-volume academic medical center and Level I Trauma environment. The coder will handle complex professional-fee coding across OB/GYN, including office visits, surgeries, and deliveries, coding with CPT and ICD-10-CM and modifiers to support compliant reimbursement. Responsibilities include coding clinics, procedures, and deliveries, reviewing provider documentation from physicians, residents, and #J-18808-Ljbffr

OB/GYN Professional Fee CoderInsight Global is seeking an OB/GYN Professional Fee Coder for a top healthcare client supporting a high-volume academic medical center and Level I Trauma environment. This candidate will handle complex professional-fee coding across a diverse OB/GYN service line, including office visits, surgical procedures, and deliveries. The coder will work with documentation from physicians, residents, and midwives while accurately assigning CPT, ICD-10-CM, and modifiers to support compliant reimbursement. This is an excellent opportunity for an experienced OB/GYN coder looking to work with complex cases spanning MFM, urogynecology, and other specialized services.Day-to-Day:Perform professional-fee coding across OB/GYN, MFM, urogynecology, and related specialty servicesCode clinic visits, surgical procedures, and deliveriesAssign accurate CPT, ICD-10-CM, and modifier coding based on provider documentationReview documentation from physicians, residents, and...

UVA Health is seeking a Lead Inpatient Coder to serve as the primary subject matter expert for hospital inpatient coding. This remote role focuses on auditing, education, and guidance to ensure the highest standards of accuracy, compliance, and reporting integrity. The ideal candidate has 5+ years of inpatient coding experience, CPC certification, and a proven ability to mentor others while working with complex cases and advanced programs in a leading academic health system. #J-18808-Ljbffr

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...

Senior Managing DirectorAnkura is a team of excellence founded on innovation and growth.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.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 private equity or strategic stakeholders.Responsibilities:Proven, tangible business development record with the ability to produce at least $3M in revenue and a target opportunity to generate $3M to $5M+ annuallyManage and deliver results for a portfolio of projects, which typically includes eight or more...

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,...

Insight Global is seeking an experienced Psychiatry Professional Fee (ProFee) Coder to join the Revenue Cycle team in Charlottesville, VA. The role focuses on accurately coding ICD-10-CM, CPT, HCPCS, and modifiers for psychiatric and behavioral health services. The candidate will review documentation, ensure coding compliance, and support charge capture initiatives while maximizing reimbursement. Experience with psychiatry guidelines, E/M services, and behavioral health documentation is #J-18808-Ljbffr

Augusta Health in Fishersville, VA is seeking a Coder II to ensure accurate ICD-10-CM, HCPCS, and CPT coding across hospital accounts. You will generate queries to physicians, support quality performance measures, and help with AR reconciliation. Responsibilities include adhering to coding standards, reporting accuracy at or above 95%, and collaborating with Business Office and ancillary departments to resolve coding issues. Eligible for comprehensive benefits and professional growth. #J-18808-Ljbffr

Pay or shift range: $23.02 USD to $35.22 USD The pay range reflects the current compensation range for this position at the time of posting. Individual offers are determined based on directly related experience, skills, education, internal equity, and other job-related factors. Not all candidates will qualify for the upper end of the posted range. Description Overview At Augusta Health, your work matters - and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer more than just a job - we offer a purpose-driven career in a nationally recognized, independent health system located in Virginia's scenic Shenandoah Valley. Our team members thrive in a supportive culture that values collaboration, integrity, and excellence. With opportunities across clinical and non-clinical areas, Augusta Health is a place where...

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....

Albany Med Health System seeks a Professional Coder to review, analyze, and validate CPT and ICD-10 codes and charges, ensuring compliance with federal and state regulations and payer guidelines. The role is remote and requires knowledge of NCCI edits and documentation standards. The position emphasizes coding accuracy, quality standards, and collaboration with providers and staff to support precise documentation and coding. Health system experience is preferred. #J-18808-Ljbffr

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...