National Association of Community Health Centers (NACHC)

A unified voice and source for research, information, training and advocacy for Community Health Centers.

Lead Coder

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteTeam 51-200Since 1971H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

16 days ago

Salary

Not specified

Professional Certificate5 yrs expEnglish

Job Description

• Provides day-to-day leadership, subject matter expertise, and operational oversight to a team of coders supporting obstetrics/gynecology and behavioral health services. • Ensures accurate, compliant, and timely coding of professional services while supporting quality, productivity, staff development, and regulatory compliance across assigned specialties. • Reviews and validates professional coding for OB/GYN and behavioral health services prior to charge entry or approval. • Ensures accurate assignment of diagnosis and procedure codes, modifiers, and units in compliance with CMS, OIG, and payer guidelines. • Provides routine coding audits and quality reviews; provides targeted feedback and education based on findings. • Identifies documentation gaps, denial trends, and compliance risks and recommends corrective actions. • Appropriately queries providers for missing, conflicting, or unclear documentation. • Reviews and resolves coding-related claim rejections and denials. • Ensures all services meet medical necessity and documentation requirements prior to billing.

Job Requirements

  • Active coding certification required (CPC, CCS, CCS-P, or equivalent).
  • Minimum of five (5) years of professional medical coding experience, in OB/GYN within a physician billing or revenue cycle environment.
  • Advanced knowledge of ICD-10-CM, CPT, and HCPCS coding guidelines, including specialty-specific rules for OB/GYN.
  • Thorough knowledge of CMS, Medicaid, and commercial payer requirements, including fraud and abuse regulations.
  • Strong working knowledge of Electronic Health Records (EHR) and physician billing systems.
  • Full knowledge of HIPAA regulations and confidentiality standards.
  • Demonstrated leadership, coaching, and communication skills.

Benefits

  • Competitive compensation
  • Medical, dental & vision plans, with an HSA/FSA option
  • 401(k) with employer match
  • Paid time off
  • Paid parental leave

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