Surgical Coder, Remote

Mass General Brigham•Somerville, MA

1d•$26 - $36•Remote

About The Position

The Surgical Coder reviews patient medical records after visits and translates clinical information into codes used by insurers to process claims. The role confirms treatments with medical staff, identifies missing information, submits information to insurers for reimbursement, and participates in peer review to maintain accuracy and timeliness. It also resolves complex coding questions raised by the team. The position evaluates outpatient documentation and coding to support accurate reimbursement and compliance with legal standards and guidelines. It interprets medical information to assign and sequence appropriate diagnosis and procedure codes, provides technical guidance on documentation and coding issues, audits coded data, researches discrepancies, and recommends corrective actions to prevent future errors. The role does not require patient care.

Requirements

High school diploma or equivalent required.
Two to three years of medical coding experience required.
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.
Strong leadership and team management skills, including the ability to motivate and develop coding team members.
Strong communication and interpersonal skills to 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.
Experience cannot be accepted in lieu of a degree.

Nice To Haves

Associate's degree in Medical Billing and Coding preferred.

Responsibilities

Evaluate medical record documentation and coding to optimize reimbursement and ensure diagnostic and procedural codes accurately reflect and support outpatient visits and comply with legal standards and guidelines.
Interpret medical information, diseases, symptoms, diagnostic descriptions, and procedures to assign and sequence the correct ICD-9-CM and CPT codes.
Provide technical guidance to physicians and other staff on incomplete or missing records, ambiguous or nonspecific documentation, and codes that do not conform to approved coding principles and guidelines.
Manage complex coding situations and support peers with challenging questions.
Peer review records for management to ensure information is accurate.
Audit clinical documentation and coded data to validate that documentation supports services rendered for reimbursement and reporting.
Research and analyze discrepancies, recommend and facilitate corrective action, and help prevent future coding errors.
Identify reportable elements, complications, and other procedures.
Confirm treatments with medical staff, identify missing information, and submit information to insurers for reimbursement.