Inpatient Coding Quality Specialist, Remote

Mass General Brigham Incorporated; Somerville (MA); Remote; USD 43,000 - 62,000; Full time

Benefits offered by this job

Remote work

Competitive benefits package

Job summary

Mass General Brigham Incorporated is seeking a Coding Quality Assurance professional to monitor, assess, and improve coding accuracy, documentation, and regulatory compliance. You will develop QA programs, analyze medical records, and deliver targeted education to coders and clinicians, ensuring adherence to AMA, CMS, and other guidelines.

The role emphasizes collaboration with providers and billing teams, establishing metrics, and driving workflow improvements in a remote, HIPAA-compliant

Qualifications

• In-depth knowledge of ICD-10, CPT, HCPCS coding systems.
• Experience interpreting medical records and documentation for accurate coding.
• Experience building and delivering coding education to staff.
• Familiarity with AMA, CMS guidelines and related regulations.

Responsibilities

• Develop and implement coding quality assurance programs to evaluate accuracy, completeness, and compliance.
• Analyze records to assess documentation sufficiency for assigned codes.
• Educate coders, physicians, and staff to improve documentation and coding accuracy.
• Identify opportunities to streamline coding workflows and improve productivity.
• Establish quality metrics and reporting to monitor coding accuracy and compliance.

Skills

ICD-10 coding

CPT coding

HCPCS coding

Quality assurance

Data analysis

Attention to detail

Communication

Independent work

Education

Associate's Degree in Medical Billing and Coding

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 SummaryResponsible 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.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.QualificationsEducationAssociate's Degree Medical Billing and Coding requiredExperience5+ years of medical coding experience required1+ years of quality assurance experience preferredStrong inpatient coding experience, academic facility preferred.Must have ICD-10 PCS coding experienceKnowledge, Skills and AbilitiesAdvanced 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.Working schedule:Remote, M-F eastern standard business hours.Requires a quiet, secure, HIPAA-compliant working area.Additional Job Details (if applicable)Remote TypeRemoteWork Location399 Revolution DriveScheduled Weekly Hours40Employee TypeRegularWork ShiftDay (United States of America)Pay Range$30.60 - $44.51/HourlyGrade6At 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 FrameworkAt 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.