Senior HIM Coding Lead: DRG Accuracy & Compliance

Valley Health System (New Jersey); Paramus (NJ); On-site; USD 56,000 - 70,000; Full time

Benefits offered by this job

Medical insurance

Dental & Vision discounts

Life insurance

Job summary

Valley Health System is seeking a Lead HIM Coding Specialist to act as a subject matter expert in inpatient coding and DRG validation. You will perform high-level reviews of coded data to ensure compliance with federal regulations and hospital policies, and collaborate with CDI, Coding, and Compliance to strengthen audit readiness.

Role emphasizes proactive denial prevention, trend analysis, and mentorship of coding staff, with a focus on DRG integrity and revenue integrity across the

Qualifications

• Minimum of 5 years inpatient coding in an acute care hospital.
• Minimum of 2 years in DRG validation, coding audit leadership, or CDI collaboration.
• Experience analyzing denial trends and audit outcomes.
• Advanced use of EHRs, encoders, and data analytics tools.

Responsibilities

• Lead high-level second-level reviews of coded data for accuracy and compliance.
• Audit MS-DRG/APR-DRG assignments and drive documentation improvements.
• Collaborate with CDI, Coding, and Compliance teams to identify trends and mitigate risk.
• Mentor and educate coding staff; oversee pre- and post-bill audits.

Skills

ICD-10-CM/PCS

MS-DRG/APR-DRG

DRG reimbursement

Regulatory knowledge

Clinical documentation reviews

Data analytics

Communication

CDI collaboration

Education

High school diploma

CCS certification

Associate or bachelor's degree preferred

RHIT/RHIA/CDIP/CDDS/CPC preferred

Tools

Meditech

EPIC

Cerner

3M Encoder

TruCode

Job description

Valley Health System is seeking a Lead HIM Coding Specialist to act as a subject matter expert in inpatient coding and DRG validation. You will perform high-level reviews of coded data to ensure compliance with federal regulations and hospital policies, and collaborate with CDI, Coding, and Compliance to strengthen audit readiness.

Role emphasizes proactive denial prevention, trend analysis, and mentorship of coding staff, with a focus on DRG integrity and revenue integrity across the