Coding and Billing Team Lead

Position Title: Coding and Billing Team Lead
Department: Coding
Reports To: Vice President of Revenue Cycle Management 
FLSA: Exempt

Position Summary
The Coding and Billing Team Lead is responsible for directing and coordinating the daily operations of the medical coding and billing team to ensure accurate, compliant, and timely billing practices. This role oversees coding and billing audits, implements and maintains coding policies and guidelines, and ensures adherence to applicable regulations. The Team Lead collaborates closely with healthcare providers and internal teams to resolve coding and billing issues, supports revenue cycle processes, and stays current with changes in coding requirements. Strong leadership, in-depth coding and billing expertise, and knowledge of relevant coding systems and guidelines are essential for success in this role.

Essential Duties & Responsibilities

• Serve as the subject matter expert for all billing and coding operations
• Lead, train, and supervise the billing and coding team, including workload management, performance monitoring, coaching, and issue resolution
• Ensure accurate, compliant, and timely coding and billing through chart review, claim audits, and error correction
• Create, submit, and monitor CMS-1500 claims and work claim rejections through the clearinghouse to resolution
• Monitor documentation completeness and collaborate with providers and clinical staff to obtain required information
• Manage and maintain coding rules that drive coding automation logic, ensuring accuracy, compliance, and alignment with payer requirements
• Ensure compliance with CPT, ICD-10, HCPCS, payer guidelines, NCDs/LCDs, and all applicable federal and state regulations
• Identify trends, denial drivers, and system or process improvements to enhance billing accuracy and reimbursement
• Maintain current knowledge of coding and regulatory updates and ensure team compliance with certifications and CEU requirements
• Review KPI and productivity reports and communicate performance outcomes to leadership
• Respond professionally and timely to inquiries from providers, staff, payers, and leadership
   

Qualifications & Requirements 

Education, Licenses/Certifications 

• Certified Professional Coder (CPC) or Certified Professional Biller (CPB) through AAPC or equivalent
• Graduate of an accredited High School or equivalent required

Experience

• Minimum of 5 years of progressive medical coding experience, including CPT, ICD-10, and HCPCS
• Minimum of 5 years of hands-on medical billing experience, including claims submission, denial management, and payer follow-up
• 3 years of supervisory or team lead experience within a coding, billing, or revenue cycle environment

Skills & Competencies:

• Excellent oral and written communication skills with a professional, friendly demeanor
• Strong organizational, time management, and multitasking abilities
• Demonstrated work ethic, flexibility, initiative, and ability to work with minimal supervision
• Proven ability to supervise, train, and coordinate staff, including prioritizing and scheduling work to meet deadlines
• Knowledge of CPT, ICD-9, and ICD-10 coding systems and medical terminology, including diagnosis codes
• Familiarity with electronic documentation systems and healthcare workflow tools
• Strong analytical and problem-solving skills with sound judgment and decision-making ability
• Ability to foster collaboration, cooperation, and teamwork across all levels
• Demonstrates professionalism, integrity, objectivity, and ethical conduct
• Proficiency with Microsoft operating systems, VOIP technology, and Microsoft Office Suite (Outlook, Excel, Word, PowerPoint)
• Familiarity with Availity and payer portals
• Knowledge of National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)

Physical Demands:

• Ability to maintain a stationary position for extended periods.
• Occasionally required to move short to moderate distances.
• Must be able to lift and/or move up to 50 pounds occasionally.

HIPAA Privacy & Confidentiality Requirements:
The Coding and Billing Team Lead will have access to confidential information, both written and oral, in the course of their employment and job responsibilities. In order to maintain the integrity of Protected Health Information (PHI), this information is not to be disclosed to any unauthorized individuals as outlined in the Policies and Procedures of NMA.
 

Disclaimer: The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Employees must be able to perform the essential functions of the position satisfactorily. Furthermore, the statements do not establish a contract for employment and are subject to change at the discretion of the Company with or without advance notice.