Clinical Coding Coordinator (Lead Coder) - Hospital Outpatient

The Rector & Visitors of the University of Virginia; Charlottesville (VA); Sur place; USD 41 000 - 63 000; Plein temps

Avantages offerts par ce poste

Medical, Dental, and Vision Insurance

Paid Time Off

Retirement Savings

Disability Insurance

Health Savings Plans

Flexible Spending Accounts

Certification and Education Support

Résumé du poste

The University of Virginia Health System is seeking a Clinical Coding Coordinator (Lead Coder) to provide expert coding oversight across hospital outpatient services. You will perform pre-bill and retrospective reviews, resolve complex coding issues, and serve as a resource to coding, CDI, and related teams to ensure adherence to coding guidelines and documentation standards.

Applicants should have RHIA or RHIT with CCS/CPC/COC credentials and 5+ years of coding experience in a major academic

Qualifications

• Education: High School Diploma or GED required.
• Active professional coding certification required (AHIMA or AAPC).
• 5+ years relevant coding experience required.

Responsabilités

• Perform pre-bill and retrospective reviews for accuracy of diagnoses, procedures and DRG/APC assignment.
• Identify and resolve coding issues delaying account completion and ensure documentation supports accuracy.
• Conduct coding quality reviews and audits for compliance with guidelines and standards.
• Mentor coding staff on complex cases and documentation requirements.
• Support internal/external audits, denial prevention, and process improvements.

Connaissances

Inpatient/outpatient coding experience

Value-based metrics knowledge

Coding quality reviews

Auditing experience

Collaboration with CDI/Quality

Strong communication skills

RHIA or RHIT with CCS/CPC/COC

Formation

High School Diploma or GED

AHIMA/AAPC certification (RHIA/RHIT/CCS/CPC/COC)

Description du poste

Clinical Coding Coordinator (Lead Coder) - Hospital Outpatient

The Clinical Coding Coordinator (Lead Coder) provides advanced coding expertise to ensure the accuracy, integrity, and completeness of coded data across hospital services. The coordinator performs pre-bill and retrospective validation reviews, resolves complex coding issues, and serves as a resource to coding, CDI, and related teams to ensure adherence to official coding guidelines and documentation standards. This role focuses on complex case review, quality oversight, and ensuring the integrity of coded data submitted for reimbursement, quality reporting, and value-based payment models.

• Performs pre-bill and retrospective reviews to validate the accuracy of diagnosis and procedure coding, sequencing, and DRG or APC assignment.

• Identifies and resolves coding issues that delay account completion and ensures documentation supports accurate capture of severity of illness and risk of mortality.

• Reviews and validates coding impacting comorbidities, patient safety indicators, hospital acquired conditions, and mortality outcomes.

• Conducts coding quality reviews and audits to ensure compliance with official coding guidelines, regulatory requirements, and organizational standards.

• Validates principal diagnoses, procedures, complications, and comorbid conditions, including appropriate MCC/CC capture and DRG assignment.

• Serves as a subject matter expert and key resource to coding staff, CDI, and other stakeholders, providing guidance on complex coding scenarios and supporting documentation improvement initiatives.

• Assists with internal and external audit activities, denial prevention efforts, and process improvement initiatives.

• Provides guidance and mentoring to coding staff related to complex cases, guidelines, and documentation requirements to support consistent and compliant coding practices.

• Assists leadership with quality initiatives, focused reviews, and special projects as assigned.

The ideal candidate for the Clinical Coding Coordinator role has:

• Recent inpatient or outpatient coding experience in a major academic medical center, with expertise in complex coding and new technologies.

• Extensive, expert-level knowledge of value-based performance measures (PSI, HAC, mortality, risk adjustment, HCCs); and other hospital quality metrics.

• Experience in coding quality reviews, auditing, or lead/educator roles.

• Proven ability to collaborate effectively with CDI and Quality teams.

• Advanced critical thinking skills with ability to interpret complex clinical documentation.

• Strong communication skills with ability to provide clear, accurate guidance on coding standards and documentation requirements.

• AHIMA credential of RHIA or RHIT with CCS, CPC, or COC.

MINIMUM REQUIREMENTS:

Education: High School Diploma, or GED required.

Experience: 5+ years of relevant coding experience required.

Licensure: Active professional coding certification required through AHIMA or AAPC, including RHIA, RHIT, CCS, CPC, or COC.

PHYSICAL DEMANDS:

This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally requires traveling some distance to attend meetings, and programs.

The pay range for this role is $30.00 - $45.68 hourly. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

• Generous Paid Time Off

• Retirement Savings

• Long-term and Short-term Disability

• Health Saving Plans, and Flexible Spending Accounts

• Certification and Education Support

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report "Best Hospitals" guide rates UVA Health University Medical Center as "High Performing" in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children's is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA's commitment to non-discrimination and equal opportunity employment.