Coding Lead

Job Summary We are seeking an experienced Coding Quality Manager to lead our Coding Quality and Audit team. This role is responsible for overseeing coding quality assurance programs, managing coding audits, and delivering education to coding professionals and providers to ensure compliance with CMS regulations, official coding guidelines, and industry standards.

The ideal candidate has extensive experience in Orthopedic Surgery and/or Evaluation & Management (E/M) coding audits, strong leadership skills, and a deep understanding of ICD-10-CM, CPT, HCPCS, and physician coding compliance

Key responsibilities

• Lead and manage the Coding Audit and Education team, providing coaching, guidance, and performance oversight.
• Develop, implement, and maintain coding quality assurance and audit programs.
• Conduct coding audits to ensure compliance with CMS regulations, coding guidelines, and organizational policies.
• Identify coding trends, compliance risks, and opportunities for process improvement.
• Develop and deliver coding education and training sessions for providers, coders, and revenue cycle teams.
• Provide coding guidance and serve as a subject matter expert on physician documentation and coding compliance.
• Review and respond to external payer, compliance, and regulatory audits.
• Monitor coding quality metrics and prepare reports for leadership.
• Ensure the team remains current on ICD-10-CM, CPT, HCPCS, CMS regulations, and annual coding updates.
• Collaborate with cross-functional teams to resolve coding and documentation inquiries.
• Drive continuous quality improvement initiatives to enhance coding accuracy and compliance