Lead Coding Specialist

Atlantic Health; Morristown (NJ); On-site; USD 85,000 - 110,000; Full time

Job summary

Atlantic Health is seeking a Lead HIM Coder to educate the coding team, manage work queues, and ensure timely, accurate billing across encounters. You will audit records, monitor DRG accuracy & coding performance, and collaborate with CDI, physicians, and Revenue Integrity to optimize documentation and reimbursement.

You will mentor coders, conduct daily audits, participate in DRG validation, and drive process improvements with Quality and ER leaders to reduce denials and improve national

Qualifications

• Onboard and coach coding staff; educate staff on coding standards.
• Audit records to improve accuracy and charging.
• Regularly review DRG accuracy and coding performance.

Responsibilities

• Manages EPIC work queues to ensure billing within 2–3 days.
• Monitors coder performance and maintains ≥95% coding/DRG accuracy.
• Educates and mentors coding staff; onboarding and coaching.
• Liaises with Coding Division, CDI, physicians, and Revenue Integrity to improve documentation and charge accuracy.
• Conducts daily coding audits and reviews PSI, Vizient, and 3M data.
• Oversees DRG validation and denial management; resolves disputes.
• Applies national coding standards and PM metrics; stays current on guidelines.
• Drives process improvements with CDI, Quality, and ER to reduce denials.
• Performs coding duties as needed to balance workload and meet goals.

Skills

EPIC queues

Coding accuracy

Mentoring staff

Documentation liaison

Revenue integrity liaison

Record auditing

Education

RHIA/RHIT certification

Tools

3M data

Vizient

Job description

A Lead HIM Coder assists in managing the coding team by educating staff and monitoring all coding functions and w ork queues. They audit records to improve the accuracy and quality of coding and charging within the team. Serves as a liaison with CDI and physicians to enhance documentation, optimize reimbursement, and support efficient AR performance.

Principal Accountabilities:

• Manages multiple EPIC work queues (WQs) to ensure timely billing and resolution of all encounters within 2–3 days.
• Monitors and audits coder performance, ensuring >/= 95% coding and DRG accuracy through regular reviews, meetings, and feedback sessions.
• Educates and mentors coding staff, providing onboarding for new coders, daily coaching, and monthly team meetings to maintain accuracy and compliance.
• Acts as a liaison between the Coding Division, CDI Program, physicians, and Revenue Integrity to improve documentation, query processes, and charge accuracy.
• Conducts daily coding audits and reviews all PSI, Vizient, and 3M data to validate coding accuracy, case quality, and performance metrics.
• Oversees the DRG validation and denial management program, resolving coding disputes and ensuring documentation supports accurate reimbursement.
• Applies national coding standards and metrics, maintaining expertise in SOI/ROM, AHRQ PSI criteria, NTAP cases, and Medicare reimbursement systems.
• Stays current on industry updates, including Medicare PPS changes, Coding Clinic guidance, and emerging trends such as SDOH and C OVID-related coding.
• Drives process improvement initiatives, collaborating with CDI, Quality, and ER leaders to enhance documentation, reduce denials, and improve national quality ratings.
• Performs coding duties as needed, supporting workload balance, reducing discharged-not-billed (DNB) cases, and meeting monthly performance goals