Inpatient Coding Quality Specialist, Remote

Mass General Brigham•Somerville, MA

18d•$31 - $45•Remote

About The Position

The Inpatient Coding Quality Specialist monitors, assesses, and improves the quality of coding processes, documentation, and compliance with coding guidelines and regulations. The role supports coding accuracy, minimizes errors, and promotes coding compliance by reviewing documentation, developing quality programs, and working with coding and healthcare stakeholders. This is a remote position with a Monday–Friday schedule during Eastern Standard business hours. The employee must have a quiet, secure, HIPAA-compliant working area. The position is scheduled for 40 hours per week and is a regular day-shift role.

Requirements

Associate's degree in Medical Billing and Coding.
At least 5 years of medical coding experience.
Strong inpatient coding experience.
ICD-10-PCS coding experience.
Advanced knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing.
Knowledge of coding guidelines and regulations, including those established by the AMA, CMS, and other relevant organizations.
Strong analytical skills and attention to detail for interpreting medical documentation and assigning appropriate codes.
Understanding of anatomy, physiology, medical terminology, and disease processes.
Excellent written and verbal communication skills for interacting with healthcare providers and billing staff.
Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
Ability to maintain a quiet, secure, HIPAA-compliant working area.

Nice To Haves

At least 1 year of quality assurance experience.
Academic-facility inpatient coding experience is preferred.

Responsibilities

Develop and implement coding quality assurance programs to evaluate the accuracy, completeness, and compliance of medical coding practices.
Ensure coding practices align with official coding conventions, guidelines, and regulatory requirements, including those established by the AMA, CMS, and other relevant organizations.
Analyze medical records, physician notes, and other documentation to assess whether documentation adequately and specifically supports assigned codes.
Develop and deliver coding education and training for coders, physicians, and other healthcare professionals to improve coding knowledge, documentation practices, and accuracy.
Identify opportunities to streamline coding workflows, increase efficiency, and improve coding accuracy.
Establish quality metrics and reporting mechanisms to monitor and track coding accuracy, productivity, and compliance.
Communicate and collaborate with healthcare providers, coders, billing staff, and other stakeholders to address coding inquiries, clarify documentation requirements, and resolve coding issues.