Senior Remote Inpatient Coding Quality Specialist

Mass General Brigham; Somerville (MA); On-site; USD 87,681,000 - 127,540,000; Full time

Job summary

Mass General Brigham, remote-friendly, seeks a QA-focused medical coder to monitor and improve the quality of coding processes. The role emphasizes ensuring adherence to AMA and CMS guidelines and evaluating documentation to support accurate code assignment.

Applicants must have ICD-10 PCS experience and strong inpatient coding background, with an emphasis on educating staff, driving efficiency, and maintaining compliance in a fast-paced healthcare environment.

Qualifications

• Associate's Degree in Medical Billing and Coding is required.
• 5+ years of medical coding experience required.
• 1+ years of quality assurance experience preferred.
• Strong inpatient coding experience, academic facility preferred.
• Must have ICD-10 PCS coding experience.

Responsibilities

• 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 AMA, 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.

Skills

ICD-10 PCS

Inpatient coding

CPT

HCPCS

Analytical skills

Education

Associate's Degree Medical Billing and Coding

Job description

Mass General Brigham, remote-friendly, seeks a QA-focused medical coder to monitor and improve the quality of coding processes. The role emphasizes ensuring adherence to AMA and CMS guidelines and evaluating documentation to support accurate code assignment.

Applicants must have ICD-10 PCS experience and strong inpatient coding background, with an emphasis on educating staff, driving efficiency, and maintaining compliance in a fast-paced healthcare environment.