Coding Quality Specialist
Mass General Brigham
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
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.
Does this position require Patient Care? No
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.
Qualifications
Education
Associate's Degree Medical Billing and Coding required
Experience
5-7 years of Medical Coding experience required
1-2 years of Quality Assurance experience preferred
Knowledge, Skills and Abilities
Advanced 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.
Additional Job Details (if applicable)
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$30.00 - $43.63/Hourly
Grade
6
EEO Statement:
Mass General Brigham Competency Framework
At 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.