Coding QA Specialist
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About this role
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Summary:-Responsible for ensuring the accuracy and quality of billing information. Reviews and audits records to maintain compliance with regulatory standards and improve data integrity, working closely with clinical staff and coders to resolve discrepancies.
Does this position require Patient Care? No
Essential Functions:
-Completing regular audits, summarizing and reporting audit results, and recommending preventative actions when errors occur.
-Identifies and corrects errors in records, ensuring proper documentation and adherence to practices.
-Identify opportunities for additional training and/or enhancements to training materials and work collaboratively with internal and external teams to help provide education and training in these areas.
-Assist with the development and delivery of regular reports on performance, trends, and other actionable insights to the QA, Training, and Operations Leadership teams.
-Document evaluations utilizing departmental quality monitoring templates, established quality standards, and quality monitoring technology.
-Develops and maintains quality assurance reports, tracking performance metrics, and identifying areas for improvement.
-Regularly and accurately report findings to the Manager and/or user via the approved scoring, tracking, and reporting mechanisms.
Qualifications
Education
Associate's Degree Healthcare Administration/ related field required.
Bachelor's degree preferred.
Can this role accept experience in lieu of a degree?
Yes
Licenses and Credentials
CPC required.
CPMA, RHIA, RHIT, CHC preferred.
Experience
5 Years of Surgical Coding experience preferred
Experience in QA/auditing, 1-3 years preferred.
Knowledge, Skills and Abilities
- Thorough knowledge of coding standards and clinical documentation requirements.
- Strong analytical and problem-solving skills.
- Excellent communication skills, with the ability to provide constructive feedback.
- Attention to detail and commitment to maintaining high-quality standards.
- Ability to work independently and manage multiple tasks simultaneously.
Additional Job Details (if applicable)
This position will be auditing for surgical coding. Experience in surgical coding is strongly preferred.
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$63,648.00 - $92,570.40/Annual
Grade
6
EEO Statement:
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
Company
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