Coding QA Specialist

Partner's Healthcare; Somerville (MA); Remote; USD 64,000 - 93,000; Full time

Job summary

Mass General Brigham is seeking a Quality Assurance Auditor to ensure the accuracy and quality of billing information. You will audit records, resolve discrepancies with clinical staff and coders, and help improve data integrity.

This remote role involves collaborating with QA, Training, and Operations leadership, developing reports, and maintaining QA templates while supporting performance metrics. The position is based at 399 Revolution Drive with a 40-hour work week.

Qualifications

• Associate's Degree Healthcare Administration/ related field required.
• Bachelor's degree preferred.
• Can this role accept experience in lieu of a degree? Yes
• 5+ years of Surgical Coding experience preferred.
• Experience in QA/auditing, 1-3 years preferred.

Responsibilities

• Completing regular audits, summarizing and reporting audit results, and recommending preventative actions when errors occur.
• Identifies and corrects errors in records, ensuring proper documentation and adherence to practices.
• Identify opportunities for additional training and/or enhancements to training materials and work collaboratively with internal and external teams to help provide education and training in these areas.
• Assist with the development and delivery of regular reports on performance, trends, and other actionable insights to the QA, Training, and Operations Leadership teams.
• Document evaluations utilizing departmental quality monitoring templates, established quality standards, and quality monitoring technology.
• Develops and maintains quality assurance reports, tracking performance metrics, and identifying areas for improvement.
• Regularly and accurately report findings to the Manager and/or user via the approved scoring, tracking, and reporting mechanisms.

Skills

Surgical coding

QA auditing

Data analysis

Communication

Attention to detail

Independent work

Education

Associate's Degree Healthcare Administration/ related field

Bachelor's degree

Job description

Site

Mass General Brigham IncorporatedMass 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 ensuring the accuracy and quality of billing information. Reviews and audits records to maintain compliance with regulatory standards and improve data integrity, working closely with clinical staff and coders to resolve discrepancies.

Does this position require Patient Care? No

Essential Functions

• Completing regular audits, summarizing and reporting audit results, and recommending preventative actions when errors occur.
• Identifies and corrects errors in records, ensuring proper documentation and adherence to practices.
• Identify opportunities for additional training and/or enhancements to training materials and work collaboratively with internal and external teams to help provide education and training in these areas.
• Assist with the development and delivery of regular reports on performance, trends, and other actionable insights to the QA, Training, and Operations Leadership teams.
• Document evaluations utilizing departmental quality monitoring templates, established quality standards, and quality monitoring technology.
• Develops and maintains quality assurance reports, tracking performance metrics, and identifying areas for improvement.
• Regularly and accurately report findings to the Manager and/or user via the approved scoring, tracking, and reporting mechanisms.

Qualifications

• Associate's Degree Healthcare Administration/ related field required.
• Bachelor's degree preferred.
• Can this role accept experience in lieu of a degree? Yes

Licenses and Credentials

• CPC required.
• CPMA, RHIA, RHIT, CHC preferred.

Experience

• 5 Years of Surgical Coding experience preferred.
• Experience in QA/auditing, 1-3 years preferred.

Knowledge, Skills and Abilities

• Thorough knowledge of coding standards and clinical documentation requirements.
• Strong analytical and problem-solving skills.
• Excellent communication skills, with the ability to provide constructive feedback.
• Attention to detail and commitment to maintaining high-quality standards.
• Ability to work independently and manage multiple tasks simultaneously.

Additional Job Details (if applicable)

• This position will be auditing for surgical coding. Experience in surgical coding is strongly preferred.

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$63,648.00 - $92,570.40/Annual

Grade

6

Compensation & Benefits

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.

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.