Coding Specialist III

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.

• 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.
• 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.

• High School Diploma or Equivalent required
• Associate's Degree Finance preferred

• Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred

• Medical coding experience 0-1 year preferred

• Proficiency in ICD-10, CPT, HCPCS, and modifiers for coding of professional fee services.
• 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.

Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.