Medical Coding Lead

J  o  b    D  e  s  c  r  i  p  t  i  o  n

JOB INFORMATION

Effective Date:

3/16/2026

Entity:

Wisconsin

Job Code:

450006

Job Title:

Medical Coding Lead

FLSA Exemption Status:

Non-Exempt

Management Level:

Individual Contributor

JOB SUMMARY

In accordance with National and UW Health Coding Guidelines, the Medical Coding Lead assists the Coding Supervisor with oversight of daily coding operations.  This may include work volume and distribution, workflow evaluations and testing.  This position may also include reviewing and reconciling reports, providing coding training within the Coding Department and performing research on coding issues. 

ESSENTIAL DUTIES

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Assist with the day-to-day oversight of coding staff and provide feedback to supervisor on coder performance

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Assist with monitoring coding work queues

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Maintain updated documentation of all workflows while assisting Supervisor with maximizing efficiencies in workflows

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Responsible for researching and answering coding questions from Coders

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Review and reconcile missed charge reports

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As directed by the Supervisor, participate in application testing and maintenance.

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Contact appropriate teams regarding system charging errors or missed charges when applicable.

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Assist with education relating to coding and charging guidelines

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Contribute to the maintenance of UW Health’s internal coding guidelines

•

Participate in training coding staff, as needed.

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Perform line level coding as needed or requested by Supervisor up to 50% of working time. Including but not limited to:
-Review information available in the electronic medical record and/or paper record to accurately code the episode of care in multiple specialty areas, including inpatient and outpatient settings.
-Communicate directly with physician and non-physician providers to resolve conflicting provider documentation to establish cause and effect relationships between conditions and further specify diagnoses and procedures documented within the medical record.
-Resolve payer denials and respond to inquiries from revenue cycle teams, processing charge corrections as appropriate.
-Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage Documents and National Coverage Documents (LCD/NCD) directives, Medically Unlikely Edits (MUEs), and Medicare Teaching Physician Guidelines, applying knowledge of applicable regulatory requirements and institutional guidelines to select appropriate codes and modifiers.
-Actively participate in and maintain coding quality and productivity processes

As needed, additional responsibilities reasonably within the scope of duties and physical requirements may be assigned.  ALL DUTIES AND REQUIREMENTS MUST BE PERFORMED CONSISTENT WITH THE UW HEALTH PERFORMANCE STANDARDS AND RESPECT FOR PEOPLE COMMITTMENTS.

X

Non-Clinical

JOB REQUIREMENTS

High School Diploma

Required

or

equivalent and Medical Coding Education

Required

3 years

progressive coding experience

Required

5 years

of coding experience in an academic medical center

Preferred

Certified Professional Coder (CPC)

Upon Hire

Required

or

Certified Outpatient Coder (COC)

Upon Hire

Required

or

Certified Inpatient Coder (CIC)

Upon Hire

Required

or

Certified Coding Specialist (CCS)

Upon Hire

Required

or

Certified Coding Specialist Physician-Based (CCS-P)

Upon Hire

Required

or

Certified Coding Associate (CCA)

Upon Hire

Required

Registered Health Information Technician (RHIT)

Preferred

Registered Health Information Administrator (RHIA)

Preferred

LICENSE, CERTIFICATIONS, AND REGISTRATIONS MUST BE MAINTAINED PER UW HEALTH POLICY. 

•

Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty and other departments within UWHC/UWMF.

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Experience with coding concepts (Current Procedural Terminology (CPT), International Classification of Disease 10th Edition-Clinical Modification (ICD-10-CM), and Health Care Procedure Coding System (HCPCS)

•

Extensive knowledge of medical terminology

•

Experience using Microsoft Office (Excel, Word, PowerPoint, Visio)

•

Extensive knowledge of Anatomy and Physiology

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Demonstrated capacity to work independently as well as in a team environment

•

Effective communication skills, written and oral

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Comfortable presenting formal presentations to both large or small groups or individuals

•

Proven organizational and time management skills

•

Strong interpersonal skills

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Ability to work independently and self-motivate as well as motivate others

•

Ability to meet deadlines

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Analytical skills with ability to manipulate and interpret data

•

Ability to problem solve and make independent decisions

•

Ability to multi-task

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Ability to collaborate and promote teamwork

PHYSICAL REQUIREMENTS/WORKING CONDITIONS

☒

Sedentary: Sedentary work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required occasionally and other sedentary criteria are met.

Up to 10#

Negligible

Negligible

☐

Light: Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in this category when it requires a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls. To be considered capable of performing a full or wide range of light work, you must have the ability to do substantially all of these activities. If someone can do light work, we determine that they can also do sedentary work, unless there are additional limiting factors such as loss of fine dexterity or inability to sit for long periods of time.

up to 20#

Up to 10# or requires significant walking or standing or requires pushing/pulling of arm/leg controls.

Negligible or constant push/pull of items of negligible weight

☐

Medium: Medium work involves lifting no more than 50 pounds at a time with frequent lifting or carrying of objects weighing up to 25 pounds. If someone can do medium work, we determine that they can also do sedentary and light work.

20-50#

10-25#

Negligible-10#

☐

Heavy: Heavy work involves lifting no more than 100 pounds at a time with frequent lifting or carrying of objects weighing up to 50 pounds. If someone can do heavy work, we determine that they can also do medium, light, and sedentary work.

50-100#

25-50#

10-20#

☐

Very Heavy: Very heavy work involves lifting objects weighing more than 100 pounds at a time with frequent lifting or carrying of objects weighing 50 pounds or more. If someone can do very heavy work, we determine that they can also do heavy, medium, light, and sedentary work.

Over 100#

Over 50#

Over 20#

Other - list any other physical requirements or bona fide occupational qualifications not indicated above:

Over 50 lbs.

UW Health does not require, nor does it expect that its employees lift more than 50 lbs unassisted. Objects in excess of 50 lbs should be lifted or moved with mechanical means or through a team lift. Employees in patient care areas are expected to utilize mechanical lifts and adhere to the "Use of Mechanical Lifts (Liko)" policy in the Patient Services Policy and Procedure Manual.

Note: The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.

THE EMPLOYEE MUST BE ABLE TO COMPLETE ALL PHYSICAL REQUIREMENTS OF THE JOB WITH OR WITHOUT AN APPROVED ACCOMODATION. Note: The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.