389 senior clinical coder jobs found

The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation, playing a critical role in ensuring coding accuracy, regulatory compliance, and appropriate reimbursement across inpatient and outpatient services. In this role, you will conduct detailed retrospective claims reviews, provide expert-level coding analysis, and support cross-functional teams including medical directors, claims operations, and quality management. This position is ideal for a highly analytical professional who thrives in a fast-paced, remote environment and is passionate about accuracy, compliance, and continuous improvement in healthcare operations. Duties & Responsibilities Serve as a subject matter expert for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding Perform DRG validation and retrospective medical claims reviews Analyze inpatient and outpatient claims for coding accuracy and reimbursement determinations Prepare clear, detailed determination letters and...

A healthcare solutions provider is seeking a Senior Clinical Coder to serve as a subject matter expert in medical coding and DRG validation. This fully remote, full-time position requires extensive experience in coding accuracy, regulatory compliance, and reimbursement processes for both inpatient and outpatient services. The ideal candidate will thrive in a fast-paced environment and is skilled in utilizing ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems. Strong analytical abilities and effective communication skills are essential for success in this role. #J-18808-Ljbffr

Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job Summary Under the direction of the DRG Supervisor or designee, conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment (DRG Validation.). Subject matter expert on medical claims coding for outpatient and inpatient services. Provides coding-related information to medical directors, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management and the claims subcontractor as needed. Functions as the designated...

Medical Records Specialty Coder Central Maine Healthcare is an integrated healthcare delivery system serving 400,000 people living in central, western and Midcoastal Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other high-quality clinical services. Responsibilities The Specialty Coder reviews and analyzes documentation present in the medical record for both inpatient and outpatient visits to ensure accuracy of diagnosis and procedure codes assigned by the Coders or Clinical Documentation Specialists (CDS) or Computer Assisted Coding (CAC) software. Coder Auditor finalizes the coding and abstracting of the...

Job Description Job Description Porter is hiring a Risk Adjustment Coder to join our Team!   Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. We deliver understanding, compassion, information, and peace of mind for your members. Driven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience.    Position Overview We are seeking a certified coder with expertise in risk adjustment coding and...

Risk Adjustment Coder Porter is hiring a Risk Adjustment Coder to join our team! Porter combines the power of analytics with the power of care. Porter is a leading healthcare IT and services platform for care and coverage coordination that optimizes outcomes and member experience. Driven by robust AI analytics, Porter's Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member's specific needs, and directs Porter's team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. By coordinating the complexities of each unique care journey, Porter helps close the gaps with the largest impact on quality measures, total cost of care, risk adjustment, and member experience. Position Overview We are seeking a certified coder with expertise in risk adjustment coding and a specialization in in-home health assessments. The ideal candidate will have a strong understanding of CMS...

Job Description Job Description Specialty Senior Medical Coder – General Surgery Location: Irving, TX COMPENSATION & SCHEDULE • $35.75/hr (Non-CGSC Certified) | $42.00/hr (CGSC Certified – General Surgery) • Monday–Friday | 8:00 AM–5:00 PM • W2 | Temp to Perm • Start Date: 03/16/2026 ROLE IMPACT: The Specialty Coder Senior – General Surgery ensures accurate, compliant coding for high-dollar inpatient and outpatient professional services. This role drives revenue integrity by reducing denials, supporting clean claims, and maintaining a minimum 95% coding accuracy rate. Success is defined by precise code assignment, strong documentation review, and consistent productivity in a remote environment. Key Responsibilities • Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with Official Coding Guidelines and AMA CPT standards • Code inpatient and outpatient Evaluation & Management (E/M) and surgical/operative procedures, generating accurate...

Job Description Job Description Senior Medical Coder – Urology/Nephrology Location Irving, TX | Onsite Compensation & Schedule • $35.75/hour – Non-Urology Certified Coder | $42.00/hour – Certified Urology Coder (CUC) • Full Time |8:00 AM - 5:00 PM • Temp to Perm (W2) • Start Date: March 16, 2026 Role Impact: The Senior Medical Coder ensures accurate, compliant coding for high-dollar and specialty professional fee accounts within Urology and Nephrology. This role directly supports clean claims, optimized reimbursement, and reduced denials by maintaining a minimum 95% coding accuracy rate. Success is defined by precision in ICD-10-CM, ICD-10-PCS, and CPT code assignment, strong collaboration with HIM (Health Information Management) and CDI (Clinical Documentation Improvement) teams, and consistent productivity performance. Key Responsibilities • Assign diagnosis and procedure codes in accordance with ICD-10-CM/PCS Official Guidelines and AMA CPT guidelines...

Job Description Job Description This is not a remote position. This position is on Site. Become a part of our caring community As Certified Medical Coder you will be accountable for timely, accurately coding and filing claims to minimize the number of claim rejections and denials. Location : CenterWell Senior Primary Care office address: Multiple locations, The Villages, FL  Certified Medical Coder Role Overview: Review medical records, provider notes, dictation and other documentation and compare to the actual codes selected by the provider.  In accordance with correct coding guidelines, correct codes and notify provider as needed. Utilize ICD9/ICD10 to code diagnosis and determine principal and significant secondary diagnoses.  Utilize CPT/HPCS to assign and sequence all codes for services rendered. Provide education and teaching to providers and clinical assistants as needed related to properly coding encounters (CPT, ICD-10 and HCC) and compliance with...

Senior Outpatient Coding Specialist - RemoteMonday - Friday 6AM-6PM ET (40 hours/week)We are seeking aJob RequirementsSenior Outpatient Coding Specialist - RemoteMonday - Friday 6AM-6PM ET (40 hours/week)We are seeking a Senior Outpatient Surgery Coder with experience in IR & Cardiology coding to join our team. This role is responsible for the accurate and timely assignment of CPT, ICD-10-CM, and applicable modifiers for IR & Cardiology procedures, ensuring compliance with official coding guidelines, payer requirements, and organizational policies. The Senior OP Surgery Coder possesses the ability to code these complex cases and contributes to quality initiatives, audits, and process improvements. The ideal candidate demonstrates knowledge of surgical anatomy, operative reports, and specialty-specific procedures, along with strong critical-thinking skills, attention to detail, and the ability to work independently while meeting productivity and quality standards. This role...

Coding Auditor Senior Candidates must reside either in Washington or Oregon to be considered for this position. Essential Responsibilities: Proficient in medical record review and translating clinical information into coded data. Identify and assign appropriate codes for diagnoses, procedures and other services rendered, while also validating any Computer Assisted Coded (CAC) assignments for dual coding. Utilizing the Code Base Charge Trigger system (CBCT) and OPTUM 360 EncoderPRO software system for professional surgical services, analyzing and maintaining systems accuracy, validity and meaningfulness for both professional and facility services. Utilizes electronic patient data system and clinical information system (EpicCare) to access patient encounter information. Abstracts and enters clinical data elements as defined by the needs of the organization. Identifies and assigns principal diagnosis and procedure codes, sequencing them as needed for proper Ambulatory Payment...

Requisition number: 2308943 Job category: Medical & Clinical Operations $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. We're 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. You'll play a key...

Drive Accuracy. Influence Outcomes. Protect Revenue. We are seeking a highly experienced Senior Risk Adjustment Coder to play a critical role in risk adjustment accuracy, audit readiness, provider education, and clinical documentation excellence. Job Title: Senior Risk Adjustment Coder Location: Newark, CA (Candidates must currently reside within approximately 100 miles of the Newark area due to onsite operational needs.) Employment Type: Full-Time (Direct Hire) Salary Range: $91,000 – $119,000 annually, based on experience, skills, and internal equity   About the Role: We are seeking a senior-level Risk Adjustment professional to support a leading healthcare organization focused on accurate HCC capture, audit readiness, documentation integrity, and provider engagement. This role is highly operational and collaborative in nature and is not a traditional production-only coding position. The ideal candidate will bring strong expertise across Risk...

Elevate your career as a Senior Risk Adjustment Coder and make a meaningful impact on Medicare Advantage programs! Join a dynamic team where your expertise in HCC coding, chart review, and provider collaboration directly influences revenue integrity and audit readiness. If you excel in compliance, audit validation, and clear communication, this opportunity is designed for you. About the Job Competitive Pay: $140,000–$170,000 annually Shift Days: Regular Business Hours Shift Time: Standard Business Hours Start Date: ASAP Department: Risk Adjustment Location: California (Bay Area preferred; remote work possible for qualified CA candidates) Duration: Full-time, permanent Benefits Competitive salary and benefits package Opportunity to impact revenue and compliance Collaborative, team-focused environment Work with leading health plans and systems Flexible work arrangements for California-based candidates Continuous professional development Required Qualifications CPC and CRC...

Job Title: Senior Coding Educator Location: Chicagoland Type: Remote Pay: target salary $65,000-90,000 Job Type: Permanent Benefits: Medical, dental, vision, and 401(k) for eligible employees About the Opportunity Our client is a top-tier, fully integrated healthcare system serving the Chicagoland area and surrounding suburbs , known for delivering high-quality, patient-centered care across a broad network of hospitals and outpatient facilities. With a large regional footprint and strong reputation for clinical excellence, this organization offers stability, growth, and the opportunity to make a meaningful impact . They are seeking a Coding Educator to support coding excellence, provider documentation improvement, and compliance initiatives across the system. Position Overview The Coding Educator is responsible for developing and delivering education programs that enhance coding accuracy, documentation quality, and regulatory compliance....

Job Posting Performs coding and abstracting duties to assure accurate completion of coding for all assigned patient records. Job Responsibility 1. Analyzes and interprets the medical record in its entirety to ensure accurate, complete and consistent selection of diagnoses and procedures to assure the production of quality healthcare data and accurate facility payment. 2. Applies understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable codes. 3. Utilizes resources and reference materials (e.g., on-line sources, manuals) to identify appropriate codes and reference code applicability, rules and guidelines. 4. Applies the Uniform Hospital Discharge Data Set (UHDDS) definitions as well as any additional regulatory guidelines and/ or coding references to select the principal diagnosis, secondary diagnoses, all significant procedures, indicating the patient's acuity, severity of illness and risk of mortality (if applicable), as...

Sr. Certified Coder Clinical Document-Coding Mgmt The Sr. Certified Coder will: In accordance with established coding principals and guidelines assigns appropriate diagnosis and procedure codes to all applicable records - (concurrently/discharge) on patient units. Collaborates with coding supervisor for managing workflow and distribution of discharged records to non-senior coding staff. Responds to inquiries from fellow coders regarding coding questions or concerns. Collaborates with clinical documentation nursing specialists to ensure quality documentation practices. Assists physicians hospital personnel and others as needed with coding and billing inquiries. Reports discharged not final billed (DNFB) problems to coding supervisor. Requirements: Knowledge of coding systems medical terminology anatomy and physiology required. A minimum of five (5) years of inpatient coding experience required. Strong interpersonal and decision-making skills required. Certified Coding...

Title: Senior Outpatient Coder Reports to: Director of Revenue Integrity Classification: Individual Contributor Location: Boston, Hybrid Job description revision number and date: V 2.0; 5.11.2026 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices in Massachusetts and across the country. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary The Senior Certified Outpatient Coder will be a part of an emerging coding team under the billing and...

Title: Sr. Specialty Physician Coder - Interventional Radiology Location: Fountain Valley, CA / Predominantly Remote Department: Document Improvement Status: Full-Time Shift: Days (8hr) Pay Range*: $35.46/hr - $51.46/hr At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare.Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability.Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary Under the direction of the Coding Compliance Manager, the Senior Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and...

Senior Outpatient Coding Specialist - RemoteMonday - Friday 6AM-6PM ET (40 hours/week)We are seeking aJob RequirementsSenior Outpatient Coding Specialist - RemoteMonday - Friday 6AM-6PM ET (40 hours/week)We are seeking a Senior Outpatient Surgery Coder with experience in IR & Cardiology coding to join our team. This role is responsible for the accurate and timely assignment of CPT, ICD-10-CM, and applicable modifiers for IR & Cardiology procedures, ensuring compliance with official coding guidelines, payer requirements, and organizational policies. The Senior OP Surgery Coder possesses the ability to code these complex cases and contributes to quality initiatives, audits, and process improvements. The ideal candidate demonstrates knowledge of surgical anatomy, operative reports, and specialty-specific procedures, along with strong critical-thinking skills, attention to detail, and the ability to work independently while meeting productivity and quality standards. This role...

Department: Finance - Revenue Cycle Career Level: L3 Reports To: Billing Lead or Revenue Cycle Manager Anchor Health is Connecticut's leading health center for the LGBTQ+ community. We deliver high-quality, evidence-based, gender-affirming, and trauma-informed medical care to a diverse patient population across the state. Our interdisciplinary model integrates primary care, HIV medicine, sexual health, behavioral health, pharmacy, and supportive services to advance health equity for LGBTQ+ people. The Role The Senior Medical Biller addresses complex billing issues and ensures claims meet payer standards and reimbursement requirements. This role works across clinical, operational, and billing teams to resolve claim issues and maintain billing accuracy across the revenue cycle. Responsibilities Investigate complex claim denials and prepare payer appeals to recover reimbursement. Review claims and documentation to ensure compliance with payer billing...