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The coding leads serve as liaisons and leaders between coding staff, the operation, and the Director.  The coding leads are recognized as the subject matter experts for coding and for meeting operational objectives.  The Lead Coder position is responsible for accurate coding of professional services from medical record documentation. Reviews, codes to complex cases and assigns correct ICD-9/10-CM diagnosis codes and CPT coding, E/M coding and level of interventional and surgical coding.  This level will also code for new and experimental treatments and therapies. The lead coders will code for multiple physician specialties. 

Minimum Requirements

• High school diploma or equivalent.
• 2 or more coding certifications, i.e. CPC or CPMA, and must maintain active certifications for continued employment
• 5 years comprehensive medical record coding, of high level CPT/HCPCs & ICD-9/10, for multi-specialty Physician’s services, including experience in an academic teaching health care organization – candidates with demonstrated abilities/skills at this level without  the full years of experience can be considered
• Demonstrated ability and experience identifying documentation improvement opportunities
• Knowledge of insurance company, third-party and government reimbursement programs; i.e. Medicare, Medicaid, MC+, etc.
• Knowledge of medical insurance billing and collection
• Extensive knowledge with CPT, ICD 9/10 CD, and HCPCS coding and medical terminology in multiple physician practice specialties
• Fluency with Medical terminology, anatomy and physiology
• Knowledge of medical information systems for physician billing
• Demonstrated proficiency in use of computer hardware and software systems, programs and devices.
• Expert level knowledge of Medicare rules and Local Carrier Determination (LCD) and national Correct Coding Initiative (NCCI) edits and proper procedure code sequencing
• Competence in physician and staff education, including proficiency in presentation preparation and delivery
• Ability to effectively communicate verbally and written with all levels of staff Detail oriented.
• Ability to work independently and in a team environment