Lead Coding Specialist

$99,900.00 - $129,900.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Summary of Job: The Lead Coding Specialist oversees coding quality and compliance across all affiliate sites, ensuring accuracy in ICD-10-CM/PCS, CPT, DRG, and APC assignments.

This role provides leadership and mentoring to coding teams, supports audits and training initiatives, and assists with compliance reviews and appeals. Through expert oversight and education, the Lead Coding Specialist promotes consistent coding standards and drives excellence in documentation and reimbursement practices. As a Lead Coding Specialist, a typical day might include: Assist KPMG Auditors in the annual audit process.

Assists internal and external Compliance counsel in external agency investigations, Corporate Integrity Agreement and Independent Review Organization reviews as required. Effectively communicates coding recommendations and reasoning for the recommendations. Maintains proper computer and written records of all review activity.

May be required to assist in the formation of Corrective Action Plans for the affiliate staff. May be required to perform other related duties. Performs classroom training in ICD10-CM/PCS and CPT coding for affiliate staff at the Corporate Coding School.

Performs periodic ICD10-CM/PCS, CPT, DRG, and APC training sessions for affiliate staff, including research and preparation of presentations and maintenance of attendance records. Performs regulatory coding research for HIM Coding Supervisors and Quality Officers. Prepares detailed written reports of review activities.

Provides EMR review training to auditors as needed. Provides mentoring and ovof Corporate Coding Specialists and mentoring of Quality Officers. Reviews Discharge Status, Admission and Discharge Dates, and other related demographic information coded and entered by affiliate staff, inclusion of HIM Coding Supervisor, and reviewed by Coding Specialists and Quality Officers, for accuracy and completeness.

Reviews DRG and APC assignments performed by affiliate staff, inclusion of HIM Coding Supervisor, reviewed by Coding Specialists and Quality Officers, for accuracy, dependent on payer and patient type. Reviews Evaluation and Management coding performed by affiliate staff, inclusion of employed physicians, for accuracy and completeness. Reviews HCPCS/CPT coding performed by affiliate staff, inclusion of HIM Coding Supervisor, for accuracy and completeness.

Reviews ICD10-CM/PCS coding performed by affiliate staff, inclusion of HIM Coding Supervisor, and reviewed by Coding Specialists and Quality Officer, for accuracy and completeness. Reviews Physician Queries performed by affiliate staff, inclusion of HIM Coding Supervisor, reviewed by Coding Specialists and Quality Officers, for necessity, and accuracy and completeness. Reviews Present on Admission (POA) indicators for all diagnoses coded and entered by affiliate staff, inclusion of HIM Coding Supervisor, reviewed by Coding Specialists and Quality Officers, for accuracy and completeness.

Reviews RAC recommendations for Medicare and Medicaid RACs and prepares appeal documents if applicable. This role might be for you if you: Utilize principles of continuous quality improvement in all work situations to assess, measure and improve organizational and department functions. Organize work sets priorities with a minimum of supervision and seeks guidance as appropriate.

Make decisions that are timely and consistent with department, objectives, policies and procedures. Demonstrate sound judgment; accepts and benefits from constructive criticism. To be considered for this opportunity, you must meet the below

Required: Must have a minimum of an Associates Degree; Bachelors degree preferred. Must have advanced coding education and training. Must have excellent interpersonal, oral, and written communication skills, Must have excellent organizational and time management skills, Must be able to work independently with minimal supervision, CCS required Must be able to utilize a personal computer with Windows and Microsoft Office software, especially Word, Excel, and PowerPoint.

Must be able to utilize the 3M Coding and Reimbursement Software system and the LYNX Software system. Must be able to utilize EPIC, SoftMed and other EMR systems for remote reviewing of medical records. Preferred: CCS-P, CPC, CPC-H, RHIT, RHIA, and/or RN also encouraged Prior coding supervisory experience and/or coding consultant experience preferred.

Why You’ll Love Working Here: At RWJBarnabas Health, our people are at the center of everything we do. Through our Total Wellbeing promise, we offer a wide range of benefits and resources to support your physical, emotional, financial, and professional wellbeing. Highlights include: Generous Paid Time Off (Vacation, Holidays, Sick Time) Medical, Dental & Vision Insurance Prescription Drug Coverage Retirement Plans Paid Parental Leave Tuition Reimbursement Student Loan Planning Support Life and Disability Insurance Wellness Programs and Flexible Spending Accounts Voluntary Benefits (like Pet Insurance) Discounts with local partners (e.g., NJ Devils, NJPAC, Verizon) Community involvement and volunteer opportunities …and more!

Why RWJBarnabas Health: RWJBarnabas Health is New Jersey’s largest and most comprehensive academic health system, committed to delivering exceptional care and creating healthier communities. We’re proud to offer a workplace that values compassion, equity, and innovation—where every team member plays a vital role. When you join us, you’re not just building a career—you’re helping to shape the future of healthcare, one person and one community at a time.

Day shift · 37.5