Coding Specialist II, Professional Billing

C999 UMass Memorial Health Care, Inc.; Worcester (MA); On-site; USD 33,000 - 48,000; Full time

Benefits offered by this job

Signing bonus available

Job summary

UMass Memorial Health is seeking a Medical Coder to join our Worcester, MA team. This non-exempt position analyzes medical records, assigns CPT/HCPCS codes, and supports timely and accurate billing.

Requirements include three years of coding/abstraction experience, ICD-CM knowledge, and a current medical coding certification. The role offers a competitive hourly range, potential signing bonus, and opportunities to contribute to hospital-wide coding initiatives.

Qualifications

• Three years of medical abstraction and coding experience.
• Knowledge of ICD-CM (current edition) and CPT, HCPCS.
• Proficient with Microsoft Office (Excel & Word).
• Interpersonal and professional communication skills.
• Equivalent combination of education and experience may be substituted for certification/licensure.

Responsibilities

• Analyze medical record documentation to assign codes per guidelines.
• Abstract and enter codes and demographics into systems.
• Resolve incomplete or missing chart documentation to expedite billing.
• Assist in coding practices improvement and staff training.
• Participate in quality assurance and performance reporting.
• Inform supervisor of backlog and document issues.
• Alert management to coding irregularities for corrective action.
• Maintain communication with coding/billing staff for efficiency.
• Complete patient abstracts mandated by regulatory agencies.

Skills

Medical coding

ICD-CM CPT HCPCS

Office software

Interpersonal skills

Education

High school diploma

Medical coding certification

Tools

Microsoft Office

Job description

Compensation and Scheduling

Exemption Status: Non-Exempt Hiring Range: $23.81 - $35.08 Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule Details: Monday through Friday

Scheduled Hours: 7 - 3:30

Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40

Cost Center: 99940 - 5446

Professional Billing Coding Union: SHARE (State Healthcare and Research Employees)

This position may have a signing bonus available.

Major Responsibilities

1. Performs analysis on medical record documentation to include review of tests/reports, and determines appropriate codes, as defined by coding guidelines and other recognized reference materials.
2. Abstracts and enters all codes and required demographic information into the UMMHC computer system, the hospital’s abstracting database, or onto encounter forms, where necessary.
3. Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.
4. May participate in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.
5. May participate in quality assurance and performance measurement reviews and reporting.
6. Informs supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner.
7. Alerts management to any coding irregularities or trends contrary to policy/procedure so that corrective measures can be taken.
8. Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.
9. Completes patient’s abstracts mandated by Federal and State regulatory agencies, Physician Peer Review, and hospital planning for optimal facility utilization (i.e. Determination of Need, Quality Assurance, research studies and Utilization Review Program).

Position Qualifications

• License/Certification/Education: Required: 1. High School education, plus medical coding certification. Preferred: 1. Training in medical terminology from an accredited program. Recognized programs include: AHIMA, NHA, and AAPC.
• Experience/Skills: Required: 1. Three years of medical abstraction and coding experience or related work experience. 2. Knowledge of ICD-CM (current edition) and CPT, HCPCS coding systems, 3rd party payer requirements and federal/state guidelines and regulations pertaining to coding and billing practices. 3. Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word. 4. Requires good interpersonal and communications skills and demonstrates professionalism when working with team members, management and other staff members. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We’re striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at [e-mail]. We will make every effort to respond to your request for disability assistance as soon as possible.

At UMass Memorial Health, everyone is a caregiver. No matter their responsibilities or title, every employee or "caregiver" fills an important role for our patients and their families every day.

Who is a caregiver? It’s not just the person who delivers the care. It’s all the people who make it work ... and make it better. Caregivers give everything that helps patients heal, from expertise to extra attention. They give clean, comfortable rooms. Fast, accurate answers. And an easier, less stressful experience. They give warm, reassuring smiles, and helping hands. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, our community and each other. And everyone, in their own unique way, plays an important role, every day.