Surgical Coder, at Partner's Somerville, Massachusetts

Partners Healthcare; United States; On-site; USD 35,000 - 50,000; Full time

Job summary

Mass General Brigham is seeking a Medical Coding Specialist to review patient records after visits and translate them into ICD-10, CPT, and HCPCS codes for insurer processing. The role involves ensuring completeness of documentation, resolving discrepancies with clinical staff, and submitting accurate information to insurers to optimize reimbursement.

The candidate will participate in peer reviews, audits, and continuous improvement of coding accuracy and timeliness.

Qualifications

• In-depth knowledge of medical coding systems (ICD-10, CPT, HCPCS).
• Ability to apply coding guidelines and industry standards.
• Experience with physician/hospital coding and reimbursement processes.

Responsibilities

• Review patient records post-visit and translate into insurer codes.
• Confirm treatments with medical staff and identify missing information.
• Submit information to insurers for reimbursement and ensure timeliness.
• Perform peer reviews and audit documentation to ensure accuracy.

Skills

ICD-10

CPT

HCPCS

Leadership

Communication

Problem solving

Education

High School Diploma

Associate degree in Medical Billing and Coding

Job description

Medical Coding Specialist

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.

Job Summary:

Responsible for reviewing patient medical records after a visit and translating the information into codes that insurers use to process claims from patients. Duties include confirming treatments with medical staff, identifying missing information and submitting information to insurers for reimbursement. Participates in peer review to ensure accuracy and timeliness standards are maintained. Resolve complex coding questions that arise from team.

Essential Functions:

• Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits and to ensure that data complies with legal standards and guidelines.
• Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-9-CM and CPT codes.
• Provides technical guidance to physicians and other staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, and/or codes that do not conform to approved coding principles/guidelines.
• Manages complex coding situations and supports peers through challenging questions.
• Peer reviews records for management to ensure accuracy of information.
• Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
• Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors.
• Identifies reportable elements, complications, and other procedures.

Qualifications:

Education: High School Diploma or Equivalent required or Associate's Degree Medical Billing and Coding preferred.

Can this role accept experience in lieu of a degree? No

Licenses and Credentials:

Experience: Medical Coding Experience 2-3 years required

Knowledge, Skills and Abilities:

In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing. Strong understanding of coding guidelines, regulations, and industry best practices. Excellent leadership and team management skills, with the ability to motivate and develop coding team members. Strong communication and interpersonal skills to effectively collaborate with healthcare providers, coders, and other stakeholders. Strong problem-solving skills to address coding-related challenges and implement effective solutions. Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.

Additional Job Details (if applicable): Remote Work Location 399 Revolution Drive Pay Range $25.50 - $36.49/Hourly Grade 5

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.