Coding Specialist, Pain Management

Site: Mass General Brigham Incorporated

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.

Summary

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.

Does this position require Patient Care? No

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

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 Type

Remote

Work Location

399 Revolution Drive

Pay Range

$25.50 - $36.49/Hourly

Grade

5

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement

0100 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. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

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.