Lead Coordinator, Coding & Billing

NAVISTA

2d•$22 - $29

About The Position

Revenue Cycle Management (RCM) contributes to Cardinal Health Practice Operations Management, which oversees the business and administrative operations of a medical practice. Revenue Cycle Management manages a team focused on a series of clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue. The revenue cycle shadows the entire patient care journey and begins with patient appointment scheduling and ends when the patient’s account balance is zero. The Lead, Coding & Billing is a hands-on senior individual contributor who provides advanced coding expertise and day-to-day operational leadership for pre-submission billing and specialty coding activities supporting Radiation Oncology, Urology and Imaging. This role supports management by ensuring high-quality coding, clean claim submission, denial prevention, and workflow accountability while serving as the primary escalation point for complex coding and billing issues.

Requirements

Active coding certification required (CPC, CCS, CRC, RHIA, or RHIT).
4–8 years Revenue Cycle experience with specialty coding focus preferred
Strong expertise in Radiation Oncology, Urology, Imaging preferred
Strong knowledge of ICD-10-CM, CPT, HCPCS, Medicare, Medicaid, Managed Care.
Bachelor’s degree or equivalent experience preferred
Prior Lead, Senior Coder, or Auditor experience preferred
Experience with GE Centricity, Unlimited financials and Power BI
Strong analytical, organizational, and communication skills
Ability to influence through expertise in a fast-paced environment
Takes the lead in effectively applying and teaching new processes and skills in order to accomplish a wide variety of assignments
Comprehensive knowledge in technical or specialty area
Ability to apply knowledge beyond own areas of expertise
Performs the most complex and technically challenging work within area of specialization
Preempts potential problems and provides effective solutions for team
Works independently to interpret and apply company procedures to complete work
Provides guidance to less experienced team members

Responsibilities

Lead daily pre-submission coding and billing operations to support timely, accurate claim submission.
Monitor In Progress, coding, and pre-bill work queues to ensure productivity standards are met.
Coordinate workloads across multiple specialties and practices.
Maintain department coverage, including PTO coordination.
Support End-of-Month close and reporting deadlines.
Serve as certified coding SME for Urology, Radiation Oncology, and Imaging.
Apply expert knowledge of ICD-10-CM, CPT, and HCPCS coding.
Review documentation for accuracy and compliance.
Perform quality audits (routine, pre-bill, policy-driven, incentive-based).
Research resolution for LCD/NCD and payer policy denials.
Analyze denial trends and AR aging using Power BI and other tools.
Identify root causes and recommend corrective action.
Resolve complex or escalated accounts independently.
Partner with Revenue Cycle and clinical leadership to implement clean claim strategies.
Provide guidance and coaching to coding and billing staff.
Deliver training and audit feedback.
Ensure adherence to SOPs, payer rules, and compliance standards.
Communicate payer and regulatory updates to staff and leadership.
Act as escalation point for complex issues.
Serve as liaison between providers, operations, and Revenue Cycle teams.
Participate in continuous improvement initiatives.