Clinical Quality Coder Lead – Hospital Based

Job Description: • Ensure compliance with regulatory coding standards, including CMS, QIOs, NCCI edits, and payer-specific requirements, while adhering to AHIMA's Standards of Ethical Coding • Review clinical documentation and diagnostic results in the EHR to assign accurate ICD-10-CM/PCS and CPT/HCPCS codes that support organizational and Clinician Services initiatives • Query providers when documentation is unclear, following established policies to ensure coding accuracy and completeness • Collaborate with cross-functional teams—including Coding, CDI, CMD, and Quality—to advance documentation improvement practices and align with enterprise goals • Participate in special projects that support documentation, compliance, and operational excellence • Promote a professional, team-oriented service culture, modeling collaboration and accountability across Clinician Services and partner departments • Identify improvement opportunities through analysis and review, partnering with leadership and team members to implement enhancements • Demonstrate technical proficiency in using EHR systems, coding software, and official coding resources to support accurate and efficient documentation • Maintain confidentiality of patient records, and report any non-compliant practices to Documentation and Risk leadership or compliance officers • Engage in continuous learning, staying current with evolving coding guidelines, terminology, and best practices through training, publications, and credential maintenance Requirements: • Prior clinical experience as a licensed and/or certified qualified healthcare practitioner in location/area of practice • MD or APP or RN or must have CRCR/CMD certification within 12 months of hire • RHIA or HIT or CCS or CCS-P or CPC; Specialty credential required within one year of employment • Completion of advanced training in revenue cycle management through a recognized or accredited program, equivalent in scope and rigor to post-secondary education • High school diploma or GED required • 5 years of experience in expert-level professional and/or facility coding, and experience in collaborating with other teams within an organization, and/or educating/training licensed clinicians • Advanced level of ICD-10- CM/PCS and/or ICD-10-CM/CPT/HCPS for a large complex health care system or medical group • Extensive knowledge of third-party reimbursement programs, state and federal regulatory issues, national and local coverage determinants, research-related restrictions, ICD-10 CM/PCS, and CPT/HCPCS coding classifications • Demonstrated proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Teams, etc.) or similar products and in patient accounting and billing systems • Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment. Benefits: • Paid Time Off programs • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability • Flexible Spending Accounts for eligible health care and dependent care expenses • Family benefits such as adoption assistance and paid parental leave • Defined contribution retirement plans with employer match and other financial wellness programs • Educational Assistance Program Apply tot his job