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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.
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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.Principal Duties and Responsibilities:
ā¢ Analyzes medical information documented in patient medical record and codes all relevant diagnoses and procedures accurately using the appropriate code set (ICD-10-CM, ICD-10-PCS,) according to the correct classification system for the inpatient encounters.
ā¢ Performs coding and related duties of very moderate/highly complex accounts using established policies and procedures in an accurate and timely manner. Applies and follows official Coding Guidelines, AHIMA standards of ethical Coding and facility/department specific policies and procedures. (May occasionally code highly complex or moderate complexity inpatient accounts as needed or requested by Senior Manager).
ā¢ Research, understand, and interpret complex coding and/or billing rules and regulations for new and/or existing diagnoses or procedures.
ā¢ Ability to explain critical thought processes and justification for highly complex coding and/or DRG scenarios to internal and external stakeholders, including physicians, clinical staff, Coding, CDI, Quality and other professionals and leadership.
ā¢ Demonstrates understanding of the Prospective Payment System methodologies (groupers, encoders, MS-DRG, APR-DRG, APC, PPS (Prospective Payment System), and payor specific methodologies as it applies to the coding classification for the encounter.
ā¢ Demonstrates commitment to integrating coding guidance and compliance standards into daily coding practices. Identify, correct and report coding related problems according to procedure.
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Memberās performance objectives as outlined by the Team Memberās immediate Leadership Team Member.
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Qualifications
Education
High School Diploma or Equivalent required
Associate's Degree Finance preferred
Licenses and Credentials
AHIMA Certification
CCS Certification is required
Certifications may include RHIT, RHIA, CCS (strongly preferred)
Must have a minimum of 2 years of experience.
Experience
2 + years of medical coding experience
Knowledge, Skills and Abilities
Proficiency in ICD-10-CM, ICD-10-PCS, MS-DRG; APR-DRG and Coding ClinicĀ
Excellent written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines are required.
Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.
Proficient with computer applications (MS Office etc.), Excellent data entry skills.
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Additional Job Details (if applicable)
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Remote Type
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Work Location
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Scheduled Weekly Hours
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Employee Type
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Work Shift
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Pay Range
$22.22 - $31.71/Hourly
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Grade
4
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EEO Statement:
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Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership ālooks likeā 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.
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