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Claims Edit Coder Jobs in Virginia (NOW HIRING)

Albanymed

Medical Billing Analyst

Broadway, VA

$46K - $65K/yr

The edits are the result of claims that have previously billed and require an increased ability to ... edit or denial. This may require consistent communication with coding or individual departments.

Albanymed

Medical Billing Analyst

Broadway, VA · On-site

$46K - $65K/yr

The edits are the result of claims that have previously billed and require an increased ability to ... edit or denial. This may require consistent communication with coding or individual departments.

Albanymed

medical billing analyst

Broadway, VA

$46K - $65K/yr

The edits are the result of claims that have previously billed and require an increased ability to ... edit or denial. This may require consistent communication with coding or individual departments.

Albanymed

Medical Billing Analyst

Broadway, VA · On-site

$46K - $65K/yr

The edits are the result of claims that have previously billed and require an increased ability to ... edit or denial. This may require consistent communication with coding or individual departments.

Albanymed

medical billing analyst

Broadway, VA · On-site

$46K - $65K/yr

The edits are the result of claims that have previously billed and require an increased ability to ... edit or denial. This may require consistent communication with coding or individual departments.

Albanymed

Medical Billing Analyst

Broadway, VA · On-site

$46K - $65K/yr

The edits are the result of claims that have previously billed and require an increased ability to ... edit or denial. This may require consistent communication with coding or individual departments.

Albanymed

medical billing analyst

Broadway, VA · On-site

$46K - $65K/yr

The edits are the result of claims that have previously billed and require an increased ability to ... edit or denial. This may require consistent communication with coding or individual departments.

Albanymed

Medical Billing Specialist

Broadway, VA · On-site

$49K - $69K/yr

Identify and present the payer trends amongst the claims that are denying. Communicate and work ... edit or denial. This may require consistent communication with coding or individual departments.

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All JobsClaims Edit Coder JobsClaims Edit Coder Jobs in Virginia

Claims Edit Coder information

What are the key skills and qualifications needed to thrive as a claims edit coder, and why are they important?

To thrive as a Claims Edit Coder, you need a solid understanding of medical coding (ICD-10, CPT, HCPCS), claims processing, and healthcare regulations, typically supported by a coding certification such as CPC or CCS. Familiarity with electronic health record (EHR) systems, claims editing software, and payer-specific coding guidelines is crucial. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately identifying and resolving coding errors. These skills ensure correct claim submission, minimize denials, and support timely reimbursement for healthcare providers.

What is a claims edit coder?

Claims Edit Coders are healthcare professionals who review and analyze medical claims to ensure they are coded accurately and comply with insurance and regulatory guidelines. They use specialized coding systems, such as ICD-10, CPT, and HCPCS, to verify that procedures and diagnoses are properly documented. Their work helps prevent billing errors, reduce claim denials, and ensure timely reimbursement for healthcare providers. Claims Edit Coders often collaborate with billing departments and healthcare providers to resolve discrepancies and improve coding accuracy.

What is the difference between Claims Edit Coder vs Claims Processing Specialist?

AspectClaims Edit CoderClaims Processing Specialist
CertificationsCertified Coding Associate (CCA), CPCNone required, but certifications can be beneficial
Work EnvironmentHealthcare facilities, insurance companies, remoteInsurance companies, healthcare providers, office setting
Primary ResponsibilitiesReview and correct claim data, ensure coding accuracyProcess claims from submission to payment, handle inquiries

Claims Edit Coders focus on reviewing and correcting claim data to ensure accurate coding, while Claims Processing Specialists handle the overall processing of claims from submission to resolution. Both roles require knowledge of insurance policies and coding, but Claims Edit Coders are more specialized in coding accuracy, whereas Claims Processing Specialists manage broader claim workflows.

What are some common challenges faced by a claims edit coder, and how can they be addressed?

Claims Edit Coders often encounter challenges such as staying updated with frequent changes in coding regulations and payer-specific requirements. Additionally, coding errors or discrepancies may arise due to incomplete or unclear documentation from providers. To address these issues, it's important to engage in ongoing education, actively communicate with clinical staff for clarification, and utilize reliable coding resources and software. Collaboration with team members and regular training can help maintain accuracy and compliance in claim submissions.
What are popular job titles related to Claims Edit Coder jobs in Virginia? For Claims Edit Coder jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Claims Edit Coder jobs in Virginia look for? The top searched job categories for Claims Edit Coder jobs in Virginia are:
What cities in Virginia are hiring for Claims Edit Coder jobs? Cities in Virginia with the most Claims Edit Coder job openings:
Claims Edit Coder jobs near you
Infographic showing various Claims Edit Coder job openings in Virginia as of August 2026, with employment types broken down into 99% Full Time, and 1% Part Time. Highlights an 77% In-person, and 23% Remote job distribution.

Coding Quality Specialist 3 - PB Neurosurgery

Virginia Department of Human Resource Management

Charlottesville, VA • On-site

$23.29 - $48.48/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 24 days ago

Virginia Alcoholic Beverage Control Authority rating

5.2

Company rating: 5.2 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

819th of 842 rated public administrative organizations

Job description

Coding Quality Specialist 3 - PB Neurosurgery

Assigns and reviews the accuracy of the diagnostic codes (ICD-10-CM) and CPT codes for providers' Evaluation and Management Services (E/M), procedures and diagnostic testing in all settings for purposes of billing, research and providing information to government and regulatory agencies. Reviews documentation in medical record to appropriately assign ICD-10-CM, CPT-4, HCPCS and modifiers within a timely manner to capture all services rendered by providers at all locations. Monitors, analyzes, and resolves charge review, claim edit, and coding-related denial trends and shares trends with supervisor, managers, and team members to facilitate root cause analysis and continuous process improvement. Reviews and resolves charge sessions that fail charge review edits, claim edits and follow-up work queues, identifies areas of opportunity based on findings/resolution of errors. Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Provides ongoing feedback based on observations from coding physician/provider documentation. Identifies opportunities for education and communicates trends to leaders. Ensures all coded services meet appropriate governmental regulations and guidelines, National Correct Coding Initiative (NCCI) or payer-specific guidelines. Utilizes available resources for assignment of codes as necessary (e.g., Diagnostic Imaging system, Lab system, Emergency, Epic, and coding reference software and/or books). Trains and mentors Coding Quality Specialists to effectively perform their job responsibilities following current coding policies and procedures at the discretion of coding leadership Assists coders with medical terminology, disease processes and surgical techniques. Assists other coders in resolving coding issues/questions. Performs peer review as directed from coding leadership. Queries physicians to obtain clarification or missing elements in the record preventing correct coding. Provides ICD-10 and CPT codes for Business Services and physician office requests regarding non-billed or non-reimbursed claims. Completes special projects as directed by coding leadership. Performs charge corrections when appropriate. Performs other duties as assigned.

MINIMUM REQUIREMENTS

  • Education: High School Diploma or GED
  • Experience: Five years of coding/clinical experience with training in 1-3 specialties
  • Licensure: Must have CPC certification through AAPC or CCS-P certification through AHIMA to qualify for all functional areas

PHYSICAL DEMANDS

This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally requires traveling some distance to attend meetings, and programs.

The pay range for this role is $23.29 - $48.48 hourly. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

  • Comprehensive Benefits Package: Medical, Dental, and Vision Insurance
  • Paid Time Off, Long-term and Short-term Disability, Retirement Savings
  • Health Saving Plans, and Flexible Spending Accounts
  • Certification and education support
  • Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report "Best Hospitals" guide rates UVA Health University Medical Center as "High Performing" in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children's is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond. The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA's commitment to non-discrimination and equal opportunity employment.

Each agency within the Commonwealth of Virginia is dedicated to recruiting, supporting, and maintaining a competent and diverse work force. Equal Opportunity Employer

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