Lead Coding Specialist

The Lead Coding Specialist will manage and mentor a team of medical coders within a healthcare facility. In this role, they will oversee Epic work queues and ensure all patient encounters are billed and resolved within two to three days. Daily audits of coding accuracy will be performed, with a focus on maintaining at least 95% precision in coding and DRG classification. The specialist will provide onboarding and ongoing training to new coders, leading daily coaching sessions and monthly team meetings to uphold compliance standards. As a key liaison, they will work closely with the Clinical Documentation Improvement (CDI) team, physicians, and Revenue Integrity to enhance clinical documentation and improve reimbursement outcomes. The position requires conducting audits using data from PSI, Vizient, and 3M systems to assess coding quality and case performance. The individual will manage the DRG validation process and resolve coding disputes to ensure accurate billing. Additionally, they will apply national coding standards related to severity of illness, risk-adjusted payment models, and Medicare reimbursement systems. Continuous learning is required to stay current with updates in Medicare payment policies, Coding Clinic guidance, and emerging trends such as social determinants of health and post-pandemic coding practices. The Lead Coding Specialist will also lead process improvement initiatives aimed at reducing claim denials and improving national quality metrics. This is a full-time, exempt position that may require coordination across clinical and financial departments to support operational goals. The role is offered through a healthcare organization originally posted on a job platform, reflecting a leadership opportunity in clinical documentation and coding integrity.

Source: Himalayas