Coding/Billing Compliance Analyst

Mass General Brigham; Somerville (MA); Remote; USD 60,000 - 90,000; Full time

Job summary

Mass General Brigham seeks a Coding/Billing Compliance Analyst to analyze and audit medical coding and billing processes. This entry-level position is essential for identifying compliance issues and improving operational efficiencies within the healthcare sector. Candidates should hold a Bachelor's degree in Health Information Management or a related field and have a keen analytical mindset to conduct audits and ensure adherence to industry regulations.

Qualifications

• 2-3 years of experience in medical coding, billing, compliance auditing, or a related role is preferred.
• In-depth knowledge of coding systems (ICD-10, CPT, HCPCS) and billing guidelines.
• Ability to work independently and collaboratively in a team-oriented environment.

Responsibilities

• Conduct comprehensive audits of medical coding and billing practices.
• Monitor coding and billing practices for compliance risks.
• Review medical documentation to ensure alignment with billed services.

Skills

Analytical skills

Attention to detail

Communication skills

Education

Bachelor's Degree in Health Information Management

Tools

Healthcare software applications

Electronic health record (EHR) systems

Job description

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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.

Summary

Job Summary

Responsible to analyze and audit medical coding and billing processes to identify potential compliance issues, discrepancies, and opportunities for improvement.

Essential Functions

• Conduct comprehensive audits of medical coding, billing, and documentation practices to assess compliance with industry regulations and internal policies.
• Monitor coding and billing practices on an ongoing basis to identify trends, patterns, and potential compliance risks.
• Stay updated on changes in coding and billing regulations, including those from CMS, CPT, and other governing bodies, to ensure compliance.
• Review medical documentation to ensure alignment with billed services and coding specificity requirements.
• Evaluate the accuracy and appropriateness of diagnostic and procedural codes assigned to medical services.
  
  

Qualifications

• Bachelor's Degree in Health Information Management or related field of study required
• 2-3 years of experience preferred in medical coding, billing, compliance auditing, or a related role within the healthcare industry
  
  

Knowledge, Skills And Abilities

• In-depth knowledge of coding systems (ICD-10, CPT, HCPCS) and billing guidelines, as well as compliance regulations related to healthcare billing and coding.
• Analytical and critical thinking skills to conduct audits and identify compliance issues.
• Excellent written and verbal communication skills to effectively communicate compliance findings and recommendations.
• Attention to detail and the ability to work independently and collaboratively in a team-oriented environment.
• Proficiency in using healthcare software applications and electronic health record (EHR) systems.
  
  

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)

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.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Legal

• Industries

  Hospitals and Health Care

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