Lead Certified Professional Coder

About CLS Health :

At CLS Health, we are redefining healthcare delivery. As Houston's largest physician-owned, physician-led healthcare system, our mission is to provide patient-centered care through innovation and operational excellence. With over 200 providers in 35+ locations and over 50 specialties, we're building a scalable healthcare system that empowers physicians and delivers unmatched quality and access for patients.

We are Looking for :

We are seeking a highly experienced and detail-oriented Lead Certified Professional Coder to help shape and optimize our coding workflows and compliance standards. This role plays a key leadership position in designing rules, audits, and education logic that directly support claim accuracy, reduce denials, and ensure payer and CMS compliance across multiple specialties.

Key Responsibilities :

• Define coding logic and business rules for :
• Claim Holds, Edits, and Denials
• Appeal types and resolution pathways
• Develop audit and education frameworks to ensure provider documentation meets requirements for CPT, ICD-10, and HCPCS coding.
• Collaborate with the Compliance Officer to maintain up-to-date adherence with CMS guidelines and payer-specific rules.
• Create and maintain clinical-to-coding mappings, workflows, and coding pathways for multi-specialty environments.
• Assist in the development of tools and systems (e.g., Coder+) that support coding workflow automation.
• Participate in coder education, documentation improvement efforts, and coding policy development.
• Stay current with changes in federal regulations, payer guidelines, and specialty-specific coding updates.

Why You'll Love Working With Us :

Full benefits package including :

Requirements

Preferred Qualifications

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