Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills perspectives and ideas we choose to lead. Applications fromprotected veterans and individuals with disabilities are strongly encouraged. GENERAL SUMMARY/ OVERVIEW STATEMENT: The Coding Specialist reports to the Coding Manager and is responsible for correct coding of professional services and upholding compliance standards. PRINCIPAL DUTIES AND RESPONSIBILITIES: The Coding Specialist is required to: Perform coding and related duties using established Professional Billing Office and Coding Services policies in an accurate and timely manner. Review medical documentation and encounter forms and assign CPT ICD9 HCPCS II and modifiers based on documentation and payor requirements. Demonstrate a commitment to integrating coding compliance standards into daily coding practices. Identify correct and report coding problems. Maintain adequate knowledge of coding compliance and reimbursement procedures. Review current literature newsletters payor policy updates and coding manuals. Resolve coding edits and denials in a timely manner. Identify opportunities to reduce denials and enhance revenue. Function as a resource to Professional Billing Office units and external customers. Research and resolve coding inquiries. Make recommendations for coding policy changes. Participate in the encounter form revision process to ensure correct coding standards are met. Develop and maintain division specific coding procedures. Complete special projects as assigned by management which require defining problems determining work sequences summarizing findings and implementing required changes. Participate in coding education for providers and coworkers. Maintain coding certification after achieving certification status. QUALIFICATIONS: Completion of a Certified Coding Specialist certificate program or Health Information Technology Program.; or Bachelors degree in medical or related discipline with one year experience in an insurance health care or related field; or Two years of college including at least twelve semester hours in medical or related field (with classes in anatomy physiology medical terminology) and two years progressively responsible experience in insurance healthcare or related field (experience may include administrative assistant in clinic setting medical assistant billing assistant ; or High school graduate with two years progressively responsible experience as described as above. Course work in anatomy and physiology medical terminology and insurance reimbursement policies and regulations is preferred. SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: Working knowledge of ICD9 and CPT4 coding for professional fee services. Basic knowledge of anatomy and physiology medical terminology and insurance reimbursement policies and regulations. Good written and verbal communication skills and the ability to prioritize and organize work to meet strict deadlines are required. Accuracy and attention to detail Proficient with computer applications (MS Office etc) good data entry skills Certification within 3 years strongly preferred and required to advance to level II WORKING CONDITIONS: The Professional Billing Office is located in the Charlestown Navy Yard campus. SUPERVISORY RESPONSIBILITY: N/A FISCAL RESPONSIBILITY: N/A
Required Experience:
Unclear Seniority
Coding Specialist I
