457 senior clinical coder jobs found

TEEMA Solutions Group is seeking a Senior Clinical Coder for a fully remote opportunity focused on inpatient facility coding and DRG validation. You will support clinical operations teams in complex medical claims reviews and ensure coding accuracy. The ideal candidate has over 5 years of clinical coding experience and a CCS certification. This role offers long-term potential for permanent employment. #J-18808-Ljbffr

Cook Systems in Phoenix, AZ is seeking a Medical Claims Coding Specialist to perform retrospective review of inpatient and outpatient claims, ensuring accurate coding and pricing determinations under the supervision of the DRG team. You will lead coding projects, train staff, and provide coding support across departments, with emphasis on ICD-10-CM/PCS, CPT, HCPCS guidance and DoD/TRICARE processes; strong communication and MS Office skills are essential. #J-18808-Ljbffr

Gostravvy is seeking a qualified candidate for a healthcare role requiring knowledge of DRG assignment and ICD-10-CM, CPT, and HCPCS Level II coding. Responsibilities include interpreting clinical documentation, managing client engagements, and supervising a team of coders. The ideal candidate will hold degrees such as BAMS, BHMS, or M.B.B.S. and possess strong management skills for overseeing portfolios. Join us to contribute to healthcare excellence. #J-18808-Ljbffr

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...

TriWest Healthcare Alliance in Phoenix, AZ offers a remote opportunity for a medical claims reviewer. This position involves conducting retrospective medical claims reviews and ensuring proper coding for inpatient and outpatient services. Ideal candidates will have relevant coding certifications and experience in claims processing. The complete package includes competitive benefits that emphasize a healthy work-life balance, with an annual salary range of $80,000 - $84,000 based on qualifications. #J-18808-Ljbffr

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

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...

Clinical Data Management Lead Manage single and multi-service projects, ensuring quality deliverables on time, within budget and to the customer's satisfaction; Provide expert skills as part of a Clinical Data Management (CDM) team to provide quality data that meet customer needs; Provide leadership to the team in the area of coding, project planning and execution, financial management, communication and milestone tracking; Viewed as an expert in coding of clinical data. Essential Functions Serve as an account lead, or internal or external point of contact on standalone coding studies or accounts Maintain post-coding dictionary up-versioning synonym and coding reconciliation to align coding to latest dictionary versions. Perform Dictionary up-versioning activities. Perform external verbatim coding of data from non-EDC sources in line with required coding dictionary versions. Manage the customer relationship for the project team including active participation in...

Senior Billing Specialist The primary responsibility of this position is to review, analyze and/or assign ICD-10 Diagnosis and CPT Codes for all E # M, procedural and/or surgery codes for professional billing. Also, should be able to code for Professional Inpatient vs Observation status. Other responsibilities include revenue integrity functions including charge capture, timely charge entry, revenue improvement initiatives and compliant documentation review. Job function include communicating with practice leaders, providers and CBO leadership on areas of concern or opportunity including open encounters and zero charges. Candidate may also be expected to assist in performing other administrative task as assigned as well as assisting other areas of the Revenue Cycle or Clinical divisions as necessary. Primary Responsibilities: Proficiently assign ICD-10, HCPCS, CPT codes and modifiers to all assigned outpatient or inpatient records for all professional coding for AMG and...

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...

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 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...

Humana Inc. is seeking a Senior Medical Coding Professional, Inpatient to support payment integrity initiatives. You will review inpatient claims for coding accuracy, DRG assignment, and compliance with guidelines, reporting to the Manager, Payment Integrity. The role involves auditing, education, and collaboration with clinical reviewers and data analysts. Required RHIA/RHIT/CCS/CIC, 5+ years inpatient coding, and strong DRG knowledge. #J-18808-Ljbffr

Senior Inpatient Medical Coder Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: 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 part in healing the health system by making sure our high standards for...

Humana Inc. seeks a Senior Medical Coding Professional, Inpatient, to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with guidelines. You will report to the Manager, Payment Integrity. You will apply ICD-10-CM/PCS coding guidelines, assess reimbursement impact, conduct retrospective audits, and collaborate with clinical reviewers and data analysts to drive accurate DRG coding and financial outcomes. #J-18808-Ljbffr

Humana Inc. is seeking a Senior Medical Coding Professional, Inpatient to support payment integrity by reviewing inpatient claims for coding accuracy and DRG assignment. You will report to the Manager, Payment Integrity. The role involves auditing, DRG validation, and collaboration with clinical reviewers to ensure compliant reimbursement and severity assessment. This is a senior position with opportunity for impact in a large health care organization. #J-18808-Ljbffr

***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)...

Senior Hospital Coder The Senior Hospital Coder is responsible for performing detailed inpatient coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding. This is a remote inpatient position. Essential Duties and Responsibilities Optimize hospital reimbursement by auditing and...

Medical Records Technician Coder IV-Lead Koniag Advisory Business Solutions, LLC, a Koniag Government Services company, is seeking a Medical Records Technician Coder IV-Lead to support KABS and our government customer in Oklahoma, OKC. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid vacation, paid sick leave and more. Join Our Team Where Precision, Integrity, and Expertise Matter. Koniag Advisory Business Solutions (KABS) is seeking highly skilled, self-directed Medical Records Coder IV (Lead) professionals to support a large-scale healthcare mission serving hospitals and clinics. This is an opportunity to bring your expertise to a team responsible for coding and billing more than 300,000 patient visits, where accuracy, compliance,...

Senior Medical Coder 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining coding accuracy and supporting revenue cycle integrity....

Hourly Pay Range: $26.61 - $39.92 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors. Medical Coder III The Medical Coder III is a senior-level position responsible for ensuring precise coding of diagnoses and procedures in compliance with established coding guidelines and regulations. This role is integral to maintaining financial accuracy and regulatory compliance within our institution. Position Highlights: Position: Medical Coder III Location: Hybrid - Skokie, IL and remote Full Time/Part Time: Full-time (40 hours per week) Hours: Monday-Friday, 8:00am-4:30pm What you will do: Assign accurate diagnostic (ICD-10-CM) and procedural (CPT) codes to medical records, demonstrating advanced proficiency in complex coding scenarios. Lead and conduct internal audits of medical records and coding work to ensure the accuracy and consistency of code assignments, providing guidance and feedback to...