Coding Specialist

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

Responsible for reviewing patient medical records after a visit and translating the information into codes that insurers use to process claims from patients. Duties include confirming treatments with medical staff, identifying missing information and submitting information to insurers for reimbursement.

Principal Duties and Responsibilities:

• Analyzes medical information documented in patient medical record and codes all relevant diagnoses and procedures accurately using the appropriate code set (ICD-10-CM, ICD-10-PCS,) according to the correct classification system for the inpatient encounters.
• Performs coding and related duties of very moderate/highly complex accounts using established policies and procedures in an accurate and timely manner. Applies and follows official Coding Guidelines, AHIMA standards of ethical Coding and facility/department specific policies and procedures. (May occasionally code highly complex or moderate complexity inpatient accounts as needed or requested by Senior Manager).
• Research, understand, and interpret complex coding and/or billing rules and regulations for new and/or existing diagnoses or procedures.
• Ability to explain critical thought processes and justification for highly complex coding and/or DRG scenarios to internal and external stakeholders, including physicians, clinical staff, Coding, CDI, Quality and other professionals and leadership.
• Demonstrates understanding of the Prospective Payment System methodologies (groupers, encoders, MS-DRG, APR-DRG, APC, PPS (Prospective Payment System), and payor specific methodologies as it applies to the coding classification for the encounter.
• Demonstrates commitment to integrating coding guidance and compliance standards into daily coding practices. Identify, correct and report coding related problems according to procedure.

Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member's performance objectives as outlined by the Team Member's immediate Leadership Team Member.

Qualifications

Education

• High School Diploma or Equivalent required

• Associate's Degree Finance preferred

Licenses and Credentials

• AHIMA Certification

• CCS Certification is required

• Certifications may include RHIT, RHIA, CCS (strongly preferred)

• Must have a minimum of 2 years of experience.

Experience

• 2 + years of medical coding experience

Knowledge, Skills and Abilities

• Proficiency in ICD-10-CM, ICD-10-PCS, MS-DRG; APR-DRG and Coding Clinic

• Excellent written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines are required.

• Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.

• Proficient with computer applications (MS Office etc.), Excellent data entry skills.

Additional Job Details (if applicable)

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$22.22 - $31.71/Hourly

Grade

4

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:

0100 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.