Lead Coding Specialist

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Oversee various EPIC work queues to guarantee prompt billing and resolution of all encounters within a timeframe of 2–3 days.

• Assess and audit coder performance, ensuring a minimum of 95% accuracy in coding and DRG.

• Provide education and mentorship to coding personnel, including onboarding, daily coaching sessions, and monthly team gatherings.

• Collaborate with the Coding Division, CDI Program, physicians, and Revenue Integrity to enhance documentation, query procedures, and charge accuracy.

• Execute daily coding audits and analyze PSI, Vizient, and 3M data.

• Manage DRG validation and denial resolution, addressing coding disputes and facilitating accurate reimbursement.

• Implement national coding standards and metrics, such as SOI/ROM, AHRQ PSI criteria, NTAP cases, and Medicare reimbursement frameworks.

• Remain informed about Medicare PPS updates, Coding Clinic recommendations, SDOH coding, and COVID-related coding guidelines.

• Propel process improvement initiatives alongside CDI, Quality, and ER leaders to refine documentation, minimize denials, and enhance national quality ratings.

• Carry out coding responsibilities as required to maintain balanced workloads, reduce discharged-not-billed cases, and achieve monthly performance targets.

⛳️ Requirements

• High School Diploma or equivalent, along with Medical Coding Education.

• Certified Coding Specialist (CCS) certification.

• A minimum of five (5) years of progressive coding experience.

• An associate or bachelor's degree in a healthcare-related field is preferred.

• More than seven (7) years of coding experience in an academic medical center is preferred.

• Physician-Based Certified Coding Specialist (CCS-P) or Certified Coding Associate (CCA) certification is preferred.

🏝️ Benefits

• Medical, Dental, Vision, and Prescription Coverage (available for full-time and part-time team members working 22.5 hours per week or more).

• Life & AD&D Insurance.

• Short-Term and Long-Term Disability options (with opportunities for supplementation).

• 403(b) Retirement Plan: Includes employer match and additional non-elective contributions.

• Paid Time Off (PTO) & Paid Sick Leave.

• Tuition Assistance, Career Advancement, and Academic Advising.

• Parental, Adoption, and Surrogacy Leave.

• Backup and On-Site Childcare services.

• Well-Being Rewards program.

• Employee Assistance Program (EAP).

• Fertility Benefits and Healthy Pregnancy Program.

• Flexible Spending Accounts and Commuter Accounts.

• Insurance options for Pets, Home & Auto, Identity Theft, and Legal matters.