Coding Quality Specialist

Reposted Yesterday
Be an Early Applicant
Somerville, MA
In-Office
30-44 Hourly
Senior level
Healthtech
The Role
Responsible for monitoring and improving coding processes and compliance, developing quality assurance programs, analyzing documentation, and delivering coding education.
Summary Generated by Built In
Site: Mass General Brigham Incorporated


 

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.


 


 

Job Summary

Summary
Responsible for monitoring, assessing, and improving the quality of coding processes, documentation, and adherence to coding guidelines and regulations by enhancing coding accuracy, minimizing errors, and promoting coding compliance.
Does this position require Patient Care? No
Essential Functions
-Develop and implement coding quality assurance programs to evaluate the accuracy, completeness, and compliance of medical coding practices.
-Ensure coding practices align with official coding conventions, guidelines, and regulatory requirements set forth by organizations such as the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other relevant bodies.
-Analyze medical records, physician notes, and other relevant documentation to assess the adequacy and specificity of documentation supporting the assigned codes.
-Develop and deliver coding education and training programs to coders, physicians, and other healthcare professionals to enhance coding knowledge, documentation practices, and coding accuracy.
-Identify opportunities to streamline coding workflows, enhance efficiency, and improve coding accuracy.
-Establish key quality metrics and reporting mechanisms to monitor and track coding accuracy, productivity, and compliance.
-Foster effective communication and collaboration with healthcare providers, coders, billing staff, and other stakeholders to address coding-related inquiries, clarify documentation requirements, and resolve coding issues.


 

Qualifications

Education

  • Associate's Degree Medical Billing and Coding required

Experience

  • 5-7 years of Medical Coding experience required

  • 1-2 years of Quality Assurance experience preferred

Knowledge, Skills and Abilities

  • Advanced knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing.

  • Knowledgeable of coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations.

  • Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes.

  • Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding.

  • Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff.

  • Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.


 

Additional Job Details (if applicable)

Physical Requirements
  • Standing Occasionally (3-33%)
  • Walking Occasionally (3-33%)
  • Sitting Constantly (67-100%)
  • Lifting Occasionally (3-33%) 20lbs - 35lbs
  • Carrying Occasionally (3-33%) 20lbs - 35lbs
  • Pushing Rarely (Less than 2%)
  • Pulling Rarely (Less than 2%)
  • Climbing Rarely (Less than 2%)
  • Balancing Occasionally (3-33%)
  • Stooping Occasionally (3-33%)
  • Kneeling Rarely (Less than 2%)
  • Crouching Rarely (Less than 2%)
  • Crawling Rarely (Less than 2%)
  • Reaching Occasionally (3-33%)
  • Gross Manipulation (Handling) Constantly (67-100%)
  • Fine Manipulation (Fingering) Frequently (34-66%)
  • Feeling Constantly (67-100%)
  • Foot Use Rarely (Less than 2%)
  • Vision - Far Constantly (67-100%)
  • Vision - Near Constantly (67-100%)
  • Talking Constantly (67-100%)
  • Hearing Constantly (67-100%)

  •  

    Remote Type

    Remote


     

    Work Location

    399 Revolution Drive


     

    Scheduled Weekly Hours

    40


     

    Employee Type

    Regular


     

    Work Shift

    Day (United States of America)

    Pay Range

    $30.00 - $43.63/Hourly

    Grade

    6
    At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

    EEO Statement:

    Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.


     

    Mass General Brigham Competency Framework

    At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

    Top Skills

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    The Company
    HQ: Somerville, Massachusetts
    11,075 Employees

    What We Do

    Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization that is committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School.

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