A Lead HIM Coder assists in managing the coding team by educating staff and monitoring all coding functions and w ork queues. They audit records to improve the accuracy and quality of coding and charging within the team. Serves as a liaison with CDI and physicians to enhance documentation, optimize reimbursement, and support efficient AR performance.
Principal Accountabilities:
Manages multiple EPIC work queues (WQs) to ensure timely billing and resolution of all encounters within 2-3 days.
Monitors and audits coder performance, ensuring >/= 95% coding and DRG accuracy through regular reviews, meetings, and feedback sessions.
Educates and mentors coding staff, providing onboarding for new coders, daily coaching, and monthly team meetings to maintain accuracy and compliance.
Acts as a liaison between the Coding Division, CDI Program, physicians, and Revenue Integrity to improve documentation, query processes, and charge accuracy.
Conducts daily coding audits and reviews all PSI, Vizient, and 3M data to validate coding accuracy, case quality, and performance metrics.
Oversees the DRG validation and denial management program, resolving coding disputes and ensuring documentation supports accurate reimbursement.
Applies national coding standards and metrics, maintaining expertise in SOI/ROM, AHRQ PSI criteria, NTAP cases, and Medicare reimbursement systems.
Stays current on industry updates, including Medicare PPS changes, Coding Clinic guidance, and emerging trends such as SDOH and C OVID-related coding.
Drives process improvement initiatives, collaborating with CDI, Quality, and ER leaders to enhance documentation, reduce denials, and improve national quality ratings.
Performs coding duties as needed, supporting workload balance, reducing discharged-not-billed (DNB) cases, and meeting monthly performance goals
At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:
We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.
We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:
Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:
Team Member Benefits
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Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.
EEO STATEMENT
Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran
Required:
High School Diploma or equivalent and Medical Coding Education
Certified Professional Coder (CPC Certification).
Five (5) years progressive coding experience.
Preferred:
Associate or bachelor''s degree in a healthcare related field.
More than Seven (7) years of coding experience in an academic medical center.
Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P) or a Certified Coding Associate (CCA) preferred.