Role Overview: The Coding Lead is responsible for the day-to-day leadership, quality, and performance of the professional coding function. This role serves as the operational backbone of the coding team - ensuring coding accuracy, compliance with payer and regulatory guidelines, and consistent throughput across a high-volume, multi-specialty surgical and procedural environment. The Coding Lead acts as the primary point of escalation for complex coding scenarios, denial-related coding issues, and provider documentation gaps, while building the SOPs, training infrastructure, and quality controls that allow the coding function to scale across multiple entities.

This is a hands-on role: the Coding Lead will code and audit alongside the team while also coaching, training, and holding coders accountable to productivity and accuracy standards.

Key Responsibilities:

• Lead and coordinate daily coding operations across assigned work queues (WQs), ensuring timely, accurate, and compliant code assignment for professional services
• Serve as subject matter expert and escalation point for complex coding scenarios, including surgical, procedural, and E/M coding for neurosurgery, spine, and related specialties
• Oversee coding inquiries and email inbox
• Monitor coder productivity, accuracy, and WQ aging; rebalance physician/provider load assignments as needed
• Conduct coding audits and quality reviews; identify error patterns and provide targeted coaching and feedback to coding staff
• Partner with the Head of RCM and Process Improvement to build and maintain coding SOPs, including escalation paths for authorization mismatches, surgical order specificity gaps, and research billing scenarios
• Identify and document denial patterns related to coding, and collaborate with billing and AR teams on root-cause resolution
• Maintain current knowledge of CPT, ICD-10, HCPCS, and payer-specific coding guidelines, including Medicare Advantage policy nuances
• Support onboarding and training of new coding staff, including certification pathway support and ongoing education
• Act as liaison between coding staff and providers/clinical operations on documentation clarity and specificity issues
• Participate in RFA, research billing, and other cross-functional coding compliance initiatives as they arise
• Provide regular performance and quality reporting to RCM leadership

Requirements

Active coding certification (CPC, CCS, or equivalent) through AAPC or AHIMA

Minimum 5 years of professional coding experience, including surgical/procedural specialty coding

Minimum 2 years in a lead, senior, or quality-review coding capacity

Strong working knowledge of CPT, ICD-10-CM, HCPCS, and NCCI/payer edit logic

Experience with Epic practice management and coding workflows

Demonstrated ability to coach and develop coding staff

Preferred Qualifications:

Coding experience specific to neurosurgery, orthopedic spine, or related surgical specialties

Experience supporting prior-authorization and RFA-related billing compliance

Familiarity with denial management and root-cause analysis processes

Exposure to multi-entity or MSO coding operations

Additional specialty certification (e.g., CPC-S, COSC)

Core Competencies:

Coding accuracy and regulatory compliance

Coaching and staff development

Cross-functional collaboration (billing, AR, clinical operations, providers)

Process documentation and SOP development

Analytical, detail-oriented problem solving

Clear, professional written and verbal communication

Tools & Systems Exposure:

Epic (coding work queues, charge review, claim edits)

3M, EncoderPro, or similar coding/encoder software

Payer portals and prior-authorization systems