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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical coding, particularly in DRG coding, while ensuring compliance with coding guidelines and payer policies. Capable of leading teams, conducting audits, and implementing performance improvement initiatives to maximize revenue capture.
Highest-signal resume keywords
Medical Coding ExpertiseDRG Coding ExperienceCPC CertificationICD-10-CM KnowledgeEHR Systems Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical CodingDRG CodingCPT CodingICD-10-CM CodingHCPCS CodingCoding AuditsPayment Integrity ProcessesRegulatory CompliancePerformance Improvement InitiativesKPI Monitoring
Soft Skills
Interpersonal SkillsCommunication SkillsAnalytical SkillsProblem-Solving SkillsDetail-Oriented
Tools & Technologies
Coding SoftwareElectronic Health Record Systems
Certifications & Qualifications
CPCCICCCS
Industry Keywords
HIPAAHITECHCMSMedicareLCDsNCDsMedical PoliciesCommercial Payer Processes
About the role
Key responsibilities & impact- Lead and manage medical coding specialists conducting accurate and timely audits across specialties
- Provide guidance, training, and mentorship to the coding team
- Oversee coding workflow, prioritize assignments, and ensure productivity and quality targets
- Communicate updates to coding guidelines, payer policies, and industry trends
- Conduct regular audits and quality checks for coding accuracy, compliance, and documentation adherence
- Collaborate with analytics, repricing, quality, and compliance departments
- Monitor KPIs and develop performance improvement initiatives
- Apply payment integrity processes to identify claim and documentation errors and maximize revenue capture
- Serve as subject matter expert on multi-specialty surgery coding and payment integrity
Requirements
What you’ll need- Bachelor’s degree in Clinical or Healthcare Information Management or a related field
- Relevant certifications (e.g. CPC, CIC, CCS for DRG) are mandatory
- Extensive experience in medical coding, focused on DRG coding
- Strong knowledge of CPT, ICD-10-CM, and HCPCS coding systems
- Proficiency with coding software and electronic health record (EHR) systems
- Strong analytical and problem-solving skills
- Excellent interpersonal and communication skills
- Detail-oriented, with commitment to coding accuracy and regulatory compliance
- Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment
- Knowledge of HIPAA, HITECH, CMS, Medicare, LCDs, NCDs, Medical Policies, and commercial payer processes and requirements