Lead, Coding Quality

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the daily operations of a small team of coding quality specialists engaged in internal auditing for hospitals and physician providers.

• Conduct audits and coding for facility inpatient, emergency room, outpatient surgery, observation, ancillary services, recurring therapy, clinic, professional services, and billing/coding edit resolution.

• Utilize ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and Level I and II modifiers.

• Collaborate with facility-specific and state billing and coding guidelines as well as Medicare Administrative Contractors across the country.

• Work together with the Coding Department on coding audits and training initiatives.

• Delegate tasks, ensure adherence to deadlines, and mentor staff on quality and compliance standards.

• Uphold compliance with departmental standards and coding practices.

• Evaluate team efficiency and performance expectations.

• Perform code reviews to evaluate quality, compliance, and risk factors.

• Detect coding discrepancies and suggest corrective measures.

• Relay audit outcomes to both staff and management.

• Keep thorough records of audits and their results.

• Review the work of team members and carry out auditing and coding individually when necessary.

• Adhere to AHIMA ethical coding standards, the company’s Code of Ethics and Business Conduct, privacy and security regulations, and internal policies.

⛳️ Requirements

• A minimum of 3 years of production coding experience, including inpatient coding in hospitals and/or physician practices, along with previous auditing experience.

• Must possess one of the following certifications: Certified Inpatient Coder (CIC) or Certified Coding Specialist (CCS).

• Certification required through AAPC (CPC or COC) or AHIMA (CCS or CCS-P).

• Familiarity with healthcare billing practices and compliant claims preparation for both governmental and commercial payers.

• Consistent, reliable, and punctual attendance is essential.

• Proficient understanding and experience with EMR and billing systems.

• Access to a phone, reliable internet connection, and current CPT and ICD-10-CM coding references.

• Maintain ongoing productivity with an accuracy rate of 95% or higher.

• Achieve a quality score of 95% or above.

• Competency in Microsoft Excel and Outlook.

• Effective and professional communication skills, both verbally and in writing.

• Capability to coordinate, analyze, observe processes, make decisions, and meet deadlines.

• Proven ability to lead and manage the work of others.

• Ability to work at a computer terminal for 6–8 hours each day.

• Occasionally able to lift and move materials weighing up to 20 lbs.

🏝️ Benefits

• Opportunities for professional development and personal growth.

• Company-sponsored training and education programs.

• Reasonable accommodations provided for individuals with disabilities.