Medical Coding Team Lead

Job Summary:

The Team Lead – Medical Coding is responsible for overseeing coding operations, ensuring high accuracy, compliance with coding guidelines, and optimal team performance. The role focuses on delivering high-quality coding output, managing audits, and maintaining adherence to industry standards such as ICD-10-CM, ICD-10-PCS, CPT, and HCPCS.

The candidate must possess strong analytical skills and demonstrate expertise in accurately coding medical records, including E&M (Outpatient and Inpatient), Same Day Surgery (SDS), and denial coding. Certification such as CPC or CCS is required.

Key Responsibilities:

• Lead and manage a team of medical coders across multiple specialties
• Ensure accurate assignment of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes
• Monitor daily productivity and quality metrics of the coding team
• Conduct periodic audits and ensure compliance with coding guidelines and standards
• Provide training, mentoring, and refresher sessions to enhance team performance
• Ensure adherence to client requirements, regulatory standards, and compliance policies
• Coordinate with QA, AR, and billing teams for seamless process alignment
• Identify coding trends, errors, and opportunities for process improvement

Key Performance Indicators (KPIs):

• Coding Accuracy: ≥ 95–98% accuracy rate
• Productivity: Charts coded per day as per specialty benchmarks
• Audit Score: Compliance with internal and external audit standards
• Turnaround Time (TAT): Completion of coding within SLA timelines
• Denial Rate (Coding-related): Reduction in coding-related denials
• Compliance Adherence: 100% adherence to coding guidelines and HIPAA
• Escalation Rate: Minimal client and internal escalations
• Training Effectiveness: Demonstrated improvement in coder performance post-training

Required Skills & Qualifications:

• Strong expertise in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems
• Mandatory certification (CPC, CCS, or equivalent)
• Good knowledge of anatomy, physiology, and medical terminology
• Familiarity with payer guidelines and regulatory requirements
• Strong auditing, analytical, and problem-solving skills
• Proven leadership and team-handling experience
• Excellent communication, reporting, and stakeholder management skills

Experience:

• 4–7 years of experience in medical coding
• 1–2 years of experience in a Team Lead, SME, or supervisory role