Surgical Coder, Remote at Partner's Healthcare in Somerville, Massachusetts

disABLEDperson Inc; Somerville (MA); Remote; USD 35,000 - 50,000; Full time

Job summary

Mass General Brigham is seeking a Medical Coding Specialist to review patient records, assign ICD-10/CPT/HCPCS codes, and support accurate outpatient billing. You will collaborate with clinicians and staff to resolve coding questions and ensure compliance.

The role emphasizes leadership, problem-solving, and independent work in a fast-paced environment, with on-site duties at 399 Revolution Drive, Somerville, MA.

Qualifications

• Evaluate documentation and coding to optimize reimbursement and ensure compliance.
• Assign ICD-9-CM and CPT codes based on medical data.
• Provide guidance to physicians and staff on coding issues.
• Manage complex coding situations and support peers.
• Peer reviews records for accuracy.
• Audit documentation and coded data for reimbursement and reporting.
• Identify discrepancies and propose corrective actions.
• Identify reportable elements, complications, and other procedures.

Responsibilities

• Evaluate documentation and coding to optimize reimbursement and ensure accuracy.
• Interpret medical information to assign and sequence the correct codes.
• Provide guidance to physicians and staff on resolving coding issues.
• Manage complex coding situations and support peers.
• Peer reviews records for accuracy of information.
• Audit documentation and coded data for reimbursement and reporting.
• Research and implement actions to correct discrepancies.

Skills

ICD-10 knowledge

CPT knowledge

HCPCS knowledge

Leadership

Communication skills

Problem solving

Independent work

Education

High School Diploma or Equivalent

Associate's Degree in Medical Billing & Coding

Tools

Medical billing software

Job description

Medical Coding SpecialistMass 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.