Coding Team Lead – Medical Coding QA (RCM)

Job Title: Coding Team Lead – Medical Coding QA (RCM)
Job Description:
• Provide limited operational oversight and quality support to the production coding team
• Maintain an active production coding workload
• Support coding accuracy, consistency, and workflow stabilization
• Serve as first-line quality and escalation resource
• Assist with audits and coder feedback
• Defer final coding policy interpretation, provider education, and corrective action plans to RCM leadership
Responsibilities:
• Perform production medical coding while supporting quality and audit initiatives
• Conduct routine internal quality reviews, including spot checks and trend-based sampling
• Review and validate modifier usage and E/M level assignments
• Review provider documentation for quality, completeness, and accuracy
• Identify documentation insufficiencies and incorrect template use
• Identify billing issues related to bundled services or incorrect CPT procedure code assignment
• Compile audit findings and prepare summaries for RCM leadership review
• Support coder feedback and clarification related to audit findings
• Serve as first-level escalation point for coding questions and recurrent documentation issues
• Immediately escalate compliance, documentation, or quality concerns
Qualifications:
• Active AAPC or AHIMA certification (CPC, CCS, or equivalent) required
• Minimum 5 years of multi-specialty production medical coding experience
• Experience conducting peer reviews or internal coding audits
• Strong English written and verbal communication skills
Preferred Qualifications:
• Experience with AdvancedMD
• Experience supporting multi-provider and/or multi-location practices
• Experience in specialties such as Podiatry, Vascular, Pathology, Pain Management, Wound Care / Skin Substitutes (data-entry level)
Skills: Medical Coding, CPT, ICD-10-CM, HCPCS, E/M Coding, Modifiers, Coding Audits, Coding Quality Assurance, Revenue Cycle Management (RCM), AAPC Certification, AHIMA Certification, CPC, CCS, AdvancedMD, Provider Documentation Review, Compliance, Multi-specialty Coding, US Healthcare Coding, English Written Fluency

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