[Hiring] Coder - Team Lead @Diana Health

Role Description

Under minimal direction, the Medical Coder Team Lead (OB/GYN & Behavioral Health) provides day-to-day leadership, subject matter expertise, and operational oversight to a team of coders supporting obstetrics/gynecology and behavioral health services. This role ensures accurate, compliant, and timely coding of professional services while supporting quality, productivity, staff development, and regulatory compliance across assigned specialties.

• Performs advanced coding functions while providing leadership and guidance to coding staff.
• Validates and assigns accurate diagnosis and procedure codes.
• Supports quality assurance, staff training, audit activities, and performance monitoring.
• Maintains objectivity in coding practices and ensures medical necessity and documentation integrity.
• Supports charge capture and revenue cycle optimization.

Qualifications

• 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.
• Prior experience in a lead, audit, quality assurance, or mentoring role preferred.
• 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.

Requirements

• 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.
• Coordinates with AR, billing, CDI, and revenue cycle teams to support timely claim resolution.

Benefits

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