Senior Coder - Professional Coding

Yale New Haven Health•New Haven, CT

About The Position

The Senior Coder is a multifaceted role within the Coding Department, serving as a Professional coding subject matter expert, educator, quality assurance reviewer, and contributor to Pre-A/R management and oversight. The role collaborates with partner departments to solve problems and streamline processes, and mentors team members while preparing them for Senior Coder responsibilities. It requires strong professional clinical coding expertise, extensive knowledge of professional coding guidelines, and the ability to manage multiple priorities in a specialty-focused, team-based environment. The Senior Coder supports day-to-day Professional Coding accounts receivable activities, conducts quality reviews, communicates findings, and helps improve coding accuracy, completeness, and timeliness. The role may include production coding based on department needs, education and mentoring, workload prioritization, and leadership coverage when a supervisor is absent.

Requirements

At least five years of progressive experience in Professional Coding.
Full proficiency in a majority of the Professional specialties defined by the department.
Prior experience with Epic.
CPC or CCS-P credential required.
Extensive knowledge of Professional coding service lines, official coding guidelines, and internal workflows.
Ability to resolve coding claim edits and general understanding of the revenue cycle.
Advanced Excel knowledge for tracking, trending, and reporting.
Ability to create dashboards, presentations, educational coding tools, and procedures using technology and/or reporting to support coding compliance, proficiency, and KPI targets.

Nice To Haves

Bachelor’s degree in a health-related field preferred.
College-level coursework in anatomy and physiology, medical terminology, pathophysiology, and disease processes strongly preferred.
Audit educator and/or coding lead support experience strongly preferred.
CCC and/or CIRCC credentials preferred; additional relevant coding certifications preferred.
AAPC-approved facilitator and/or education preferred.

Responsibilities

Collaborate with the Coding Leadership team to manage and assist with day-to-day Professional Coding A/R activities, ensuring accurate, complete, and timely charge review.
Serve as a Professional coding subject matter expert on coding and workflows for staff and partner departments.
Conduct regular quality assurance reviews to identify coding errors and trends, communicate findings, and monitor cases for improvement.
Work with the Professional training and education team on quality findings and trends; as needed, help educate and train internal staff or vendors with an audit educator.
Code across all Professional coding specialties (four or more specialty types as defined by the department), maintain at least a 95% overall coding quality score in diagnostic, procedural, and modifier code selection, and perform production coding as needed to reduce outstanding A/R.
Pursue ongoing coding education, attend education sessions, lead learning circles, and share relevant information with team members.
Work with audit educators to mentor team members and provide coding support.
Prioritize coding workload to focus on cases and service lines that can affect department goals; guide team members on workload prioritization when needed to improve A/R.
Provide staff support in a lead capacity when the supervisor is absent and may cover for the vendor coordinator.
Perform other duties and special projects requested by the manager.
Remain engaged in department goals and vision, embrace educational opportunities, model professional standards of behavior, and encourage staff to do the same.