Medical Coding Specialist Jobs in Virginia
Medical Coding Specialist jobs in Virginia represent one of the more active markets on the East Coast, with demand concentrated in hospital systems, outpatient clinics, and government-affiliated health networks at levels from entry-level coder through senior auditor. The heaviest hiring is centered in Northern Virginia, Richmond, and the Hampton Roads area, where large employers including Inova Health System, VCU Health, and Sentara Healthcare maintain consistent coding workforces. Outpatient facility coding, HCC risk adjustment, and surgical coding are the most in-demand specialties across Virginia postings. Find a role that fits below and apply directly.
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See related jobsWe’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends.
Conduct a comprehensive medical record review to ensure the CPT/HCPCS/Revenue codes and/or modifiers billed are consistent with medical record documentation.- Provide detailed written summary of medical record review findings.
- Must be able to articulate findings to investigators, plan leadership, law enforcement, legal counsel, providers, state regulators, etc.
- Research and accurately apply state or CMS guidelines related to the review with minimal support.
- Review and discuss cases with Medical Directors to validate decisions.
- Assist with investigative research related to coding questions, state and federal policies.
- Identify potential billing errors, abuse, and fraud.
- Identify opportunities for savings related to potential cases which may warrant a prepayment review.
- Maintain appropriate records, files, documentation, etc.
- Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
- Maintains up-to-date coding knowledge, including new changes to coding compliance and reimbursement.
Required Qualifications
- AAPC CPC certification
- Minimum of 3 years of experience in medical and/or behavioral health professional coding, with at least 1-2 years of current professional coding experience, including medical record review and documentation auditing.
- Knowledge of professional medical coding systems, including CPT, HCPCS, and Revenue Codes.
- CMS 1500 and UB04 data elements.
- Demonstrated ability to interpret, apply, and consistently apply established coding policies and guidelines.
- Experience with Microsoft products; Excel and Word.
- Ability to travel for the role, if needed.
- CPMA certification
- Credentials such as certification from the Association of Certified Fraud Examiners (CFE) or an accreditation from the National Health Care Anti-Fraud Association (AHFI).
- Experience performing coding and audit functions within a health plan or payer environment.
- Strong attention to detail and ability to review and interpret data.
- Demonstrates strong written and verbal communication skills.
Education
- AAPC Certified Professional Coder Certification (CPC).
- GED or High School diploma.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$43,888.00 - $93,574.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 11/13/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends.
Conduct a comprehensive medical record review to ensure the CPT/HCPCS/Revenue codes and/or modifiers billed are consistent with medical record documentation.- Provide detailed written summary of medical record review findings.
- Must be able to articulate findings to investigators, plan leadership, law enforcement, legal counsel, providers, state regulators, etc.
- Research and accurately apply state or CMS guidelines related to the review with minimal support.
- Review and discuss cases with Medical Directors to validate decisions.
- Assist with investigative research related to coding questions, state and federal policies.
- Identify potential billing errors, abuse, and fraud.
- Identify opportunities for savings related to potential cases which may warrant a prepayment review.
- Maintain appropriate records, files, documentation, etc.
- Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
- Maintains up-to-date coding knowledge, including new changes to coding compliance and reimbursement.
Required Qualifications
- AAPC CPC certification
- Minimum of 3 years of experience in medical and/or behavioral health professional coding, with at least 1-2 years of current professional coding experience, including medical record review and documentation auditing.
- Knowledge of professional medical coding systems, including CPT, HCPCS, and Revenue Codes.
- CMS 1500 and UB04 data elements.
- Demonstrated ability to interpret, apply, and consistently apply established coding policies and guidelines.
- Experience with Microsoft products; Excel and Word.
- Ability to travel for the role, if needed.
- CPMA certification
- Credentials such as certification from the Association of Certified Fraud Examiners (CFE) or an accreditation from the National Health Care Anti-Fraud Association (AHFI).
- Experience performing coding and audit functions within a health plan or payer environment.
- Strong attention to detail and ability to review and interpret data.
- Demonstrates strong written and verbal communication skills.
Education
- AAPC Certified Professional Coder Certification (CPC).
- GED or High School diploma.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$43,888.00 - $93,574.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 11/13/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
See All 5 Medical Coding Specialist Jobs in Virginia
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Find JobsMedical Coding Specialist Jobs by City in Virginia
Where Virginia roles are concentrated, by current openings.
Medical Coding Specialist Job Market in Virginia
A snapshot from current Virginia openings, updated as new roles post.
Who's Hiring
What Virginia Employers Look For
The qualifications that appear most often in medical coding specialist jobs across Virginia.
- CPC, CCS, or equivalent AAPC or AHIMA certification recognized by Virginia employers
- Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding systems
- Experience with electronic health record platforms such as Epic or Cerner
- Knowledge of medical terminology, anatomy, and physiology relevant to coded specialties
- Familiarity with CMS guidelines, payer-specific policies, and compliance standards
- Strong attention to detail with ability to meet productivity and accuracy benchmarks
Medical Coding Specialist Jobs in Virginia: Frequently Asked Questions
How do you become a medical coding specialist in Virginia?
Virginia does not require a state-issued license to work as a medical coding specialist, but virtually all employers in the state expect a nationally recognized credential such as the CPC from AAPC or the CCS from AHIMA. Most candidates complete a medical coding certificate or associate degree program at a Virginia community college, then sit for a credentialing exam before applying. Programs at Northern Virginia Community College and Reynolds Community College are common starting points for Virginia candidates.
How much do medical coding specialists make in Virginia?
Medical coding specialists in Virginia earn a median of about $53,290 a year, based on May 2025 Bureau of Labor Statistics wage data, ranging from around $37,630 for the lowest 10% to over $78,680 for the top 10%. Pay rises with experience, specialty, and employer.
Which companies hire medical coding specialists in Virginia?
Employers hiring medical coding specialists in Virginia right now include Amazon, CVS Health, and Northern VA Community College, based on current listings on Migrate Mate as of October 2026. Virginia's concentration of large integrated health systems and federal government health contractors means both clinical and administrative coding roles open regularly across the state.
Which Virginia cities have the most medical coding specialist jobs?
The cities with the most medical coding specialist openings in Virginia are Richmond, Virginia, and Hampton. Northern Virginia's density of hospital networks and federal health agencies drives a large share of postings, while Richmond and Hampton Roads reflect the footprints of major regional systems like VCU Health and Sentara Healthcare, which generate consistent coding demand across both inpatient and outpatient settings.
How can I get hired as a medical coding specialist in Virginia with little or no experience?
The most realistic entry path is completing a medical coding certificate program and earning a CPC-A or CCA credential before applying to entry-level coding positions at Virginia's large health systems. Inova, Sentara, and VCU Health periodically post coding trainee or coding auditor associate roles that are open to newly credentialed candidates. Lateral moves from medical billing, health information technician, or patient access roles within those same systems are another common way in, since internal candidates already familiar with EHR workflows are often preferred over outside applicants.
Where can I find and apply to medical coding specialist jobs in Virginia?
You can find and apply to medical coding specialist jobs in Virginia on Migrate Mate, which lists current Virginia openings updated regularly. Find roles that fit your experience and credentials and apply directly to the employers posting them.
See All 5 Medical Coding Specialist Jobs in Virginia
Find roles in Virginia that match your experience and apply in just a few clicks.
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