Senior Inpatient Coding Lead: DRG & Compliance Expert

01 The Valley Hospital; Ridgewood (NJ); On-site; USD 118,341,000 - 147,913,000; Full time

Benefits offered by this job

Medical/Dental/Vision Discount Program

Group Term Life Insurance and AD&D

Flexible Spending Accounts and Commut/

Job summary

Valley Health System in Ridgewood 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 second-level reviews of coded data, drive documentation improvements, and collaborate with CDI, Coding, and Compliance teams to strengthen audit readiness and revenue integrity.

The role requires CCS certification, 5+ years in inpatient coding, and experience with DRG methodologies and auditors.

Qualifications

• Inpatient coding experience in an acute care hospital.
• Minimum of 5 years inpatient coding experience.
• Minimum of 2 years in DRG validation, coding audit leadership, or CDI collaboration.
• Experience with denial trends analysis and documentation variances.

Responsibilities

• Perform high-level second-level reviews of coded data for accuracy and DRG validation.
• Audit MS-DRG/APR-DRG assignments and drive documentation improvements.
• Mentor and educate coding staff; lead coder training initiatives.
• Collaborate with CDI, Coding, and Compliance to identify trends and mitigate risk.
• Support audit readiness and proactive denial prevention.

Skills

ICD-10-CM/PCS expertise

MS-DRG/APR-DRG knowledge

DRG reimbursement knowledge

CMS/OIG compliance knowledge

data analytics

communication and negotiation

CDI collaboration

audits and denial trends

pre- and post-bill audit workflows

Education

CCS certification

AS/BS in HIM or related field

RHIT/RHIA/CDIP/CCDS/CPC certifications preferred

Tools

Meditech

EPIC

Cerner

3M encoder

TruCode

Excel

Job description

Valley Health System in Ridgewood 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 second-level reviews of coded data, drive documentation improvements, and collaborate with CDI, Coding, and Compliance teams to strengthen audit readiness and revenue integrity.

The role requires CCS certification, 5+ years in inpatient coding, and experience with DRG methodologies and auditors.