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Job Summary
SummaryResponsible to analyze and audit medical coding and billing processes to identify potential compliance issues, discrepancies, and opportunities for improvement.
Essential Functions
-Conduct comprehensive audits of medical coding, billing, and documentation practices to assess compliance with industry regulations and internal policies.
-Monitor coding and billing practices on an ongoing basis to identify trends, patterns, and potential compliance risks.
-Stay updated on changes in coding and billing regulations, including those from CMS, CPT, and other governing bodies, to ensure compliance.
-Review medical documentation to ensure alignment with billed services and coding specificity requirements.
-Evaluate the accuracy and appropriateness of diagnostic and procedural codes assigned to medical services.
Qualifications
Bachelor's Degree in Health Information Management or related field of study required
2-3 years of experience preferred in medical coding, billing, compliance auditing, or a related role within the healthcare industry
Knowledge, Skills and Abilities
In-depth knowledge of coding systems (ICD-10, CPT, HCPCS) and billing guidelines, as well as compliance regulations related to healthcare billing and coding.
Analytical and critical thinking skills to conduct audits and identify compliance issues.
Excellent written and verbal communication skills to effectively communicate compliance findings and recommendations.
Attention to detail and the ability to work independently and collaboratively in a team-oriented environment.
Proficiency in using healthcare software applications and electronic health record (EHR) systems.
Additional Job Details (if applicable)
Remote Type
Remote
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$62,400.00 - $90,750.40/Annual
Grade
6
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. 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.
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