Coding Specialist II, Remote

Mass General Brigham•Somerville, MA

1d•Remote

About The Position

Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations. This role does not involve direct patient care. The Coding Specialist II will assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information. They will ensure compliance with coding guidelines from organizations like the AMA and CMS, analyze medical records, and maintain high accuracy for proper reimbursement. The role also involves utilizing coding software and EHR systems, supporting coding compliance efforts through audits and reviews, and maintaining accurate records of coding activities.

Requirements

High School Diploma or Equivalent required
Medical Coding Experience 3-5 years required in Primary Care, Endocrine, Geriatrics, Urgent Care, Infectious Disease.
Emphasis on strong skills for ICD 10 and EM leveling.
In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing.
Familiar with 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.

Nice To Haves

Associate's Degree Medical Billing and Coding preferred
Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred

Responsibilities

Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information.
Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies.
Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes.
Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials.
Utilize coding software, encoders, and electronic health record systems to facilitate the coding process.
Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives.
Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges.