Coder - Lead

Responsibilities

• Adheres to the Standards of Ethical Coding as set forth by AHIMA and/or AAPC and remains current with official coding guidelines, regulatory updates, and payer requirements
• Works collaboratively with HIM management to support coding audit processes that promote quality, accuracy, and compliance
• Monitors daily activity of coding work queues to support productivity benchmarks and turnaround times; communicates trends, barriers, or risks to HIM management
• Serves as a mentor and resource to coding staff; assists with onboarding, training, and cross-training to support departmental coverage needs
• Collaborates with Patient Financial Services, Revenue Integrity, Compliance, CDI, and other stakeholders to identify and resolve coding-related issues impacting reimbursement or compliance
• Formulates compliant coding queries when provider documentation is incomplete, ambiguous, or unclear
• Affords education and guidance to providers and clinical teams related to documentation, coding, and reimbursement best practices
• Escalates operational, compliance, or performance-related concerns to the Coding Supervisor and/or HIM Coding Manager
• Performs other duties as assigned by HIM leadership

Requirements

• Minimum of 3 years of professional coding experience in inpatient and/or outpatient settings
• RHIA, RHIT, CCS, or CPC credential
• Demonstrated knowledge of State, Federal, and payer-specific regulations pertaining to documentation, coding, and billing
• Advanced knowledge of ICD-10-CM, CPT, and PCS coding guidelines
• Strong understanding of reimbursement methodologies (DRG, APC/E-APG, etc.) and revenue cycle workflows
• Proficiency in EHR and coding systems (e.g., Care Connect, UDS, Clintegrity)
• Demonstrated ability to mentor, train, and support staff in coding best practices
• Excellent problem-solving, communication, and collaboration skills

Qualifications

Associate's degree.

Demonstrated knowledge of State, Federal, and payer-specific regulations pertaining to documentation, coding, and billing.

Advanced knowledge of ICD-10-CM, CPT, and PCS coding guidelines.

Strong understanding of reimbursement methodologies (DRG, APC/E-APG, etc.) and revenue cycle workflows.

Proficiency in EHR and coding systems (e.g., Care Connect, UDS, Clintegrity).

Demonstrated ability to mentor, train, and support staff in coding best practices.

Excellent problem-solving, communication, and collaboration skills.