Medical Coding Team Lead – Surgery & Payment Integrity

Medical Coding Team Lead – Surgery & Payment Integrity is responsible for overseeing a team of medical coding specialists to ensure accurate, compliant, and timely auditing of surgical procedures across multiple specialties. This role demands strong technical expertise in CPT, ICD-10, and HCPCS coding, particularly within surgery and complex procedure coding domains such as cardiovascular, IVR, and general surgery

Team Leadership & Management: Lead, mentor, and manage a team of medical coding specialists to deliver high-quality auditing outcomes. Foster a collaborative, accountable, and performance-driven team culture.

Quality & Compliance: Ensure all coding and auditing activities adhere to the latest industry standards, payer guidelines, and regulatory requirements. Conduct regular audits to maintain accuracy and compliance.

Training & Development: Provide continuous education, coaching, and feedback to the coding team to enhance their technical skills and domain expertise.

Workflow Oversight: Manage coding workflow, prioritize daily assignments, and monitor progress to ensure timely completion of audit deliverables and achievement of productivity and accuracy targets.

Regulatory Updates: Stay abreast of changes in coding guidelines, payer policies, and CMS updates. Effectively communicate these updates and their operational impact to the team.

Cross-Functional Collaboration: Partner with analytics, repricing, compliance, and quality departments to resolve coding discrepancies, streamline processes, and enhance overall audit efficiency.

Performance Monitoring: Track key performance indicators (KPIs), identify performance gaps, and develop improvement strategies to boost team productivity and quality outcomes.

Payment Integrity: Apply strong knowledge of payment integrity principles to identify claim errors, documentation deficiencies, and missed revenue opportunities, ensuring optimal claim accuracy and reimbursement.

Subject Matter Expertise: Act as a coding and auditing expert for surgical specialties, supporting physicians, clinical teams, and business stakeholders in achieving accurate and compliant documentation and coding practices

• Medical Coding or Auditing experience in Surgery Coding (outpatient, Prof, APC, ASC etc.)
• CPC, COC or other AAPC/AHIMA coding certification
• Open for an IC role (Independent Contributor)
• Auditing experience – desired
• Radiation Oncology coding/auditing experience – desired
• 10+ years relevant coding experience

1. Understand the payer process of Surgery, APC, Outpatient.
2. Application of coding and clinical information.
3. Provide inputs and solutions to automatically recognize and extract data from medical documents for proper coding and to facilitate auditing.
4. Prompt response to all the emails and requirements.
5. Reporting to the manager as appropriate.
6. Excellent project management skills, multi-tasking, training skills.
7. Strong PC skills; Excel, Word, PowerPoint and internet-based programs
8. Excellent verbal and written communication 
9. Experience in Strategic management 
10. Perform analysis of benchmarking.
11. Research updated coding information
12. Research coding issues that arise
13. Maintain knowledge of Surgery coding and clinical concepts. 
14. Flexibility