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Exemption Status:

Hiring Range:

Please note that the final offer may vary within this range based on a candidates experience skills qualifications and internal equity considerations.

Schedule Details:

Scheduled Hours:

Shift:

Hours:

Cost Center:

This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

Everyone Is a Caregiver

At UMass Memorial Health everyone is a caregiver regardless of their title or responsibilities. Exceptional patient care academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts and a place where we can help you build the career you deserve. We are more than 20000 employees working together as one health system in a relentless pursuit of healing for our patients community and each other. And everyone in their own unique way plays an important part every day.

I. Major Responsibilities:

1. Responds to and resolves complicated coding requests/questions from providers Department Administrators and CBO staff.
2. Communicates regularly with the PB CBO Managers to maximize reimbursement effectiveness and efficiency of overall office function and performances.
3. Participates in educational sessions for providers Department Administrators and PB CBO Staff.
4. Develops and implements standardized coding charge entry and billing business rules and processes.
5. Monitors and implements changes to ICD/CPT coding requirements and determines impact of such changes on current billing practices along with development of action plans to ensure compliance with said changes.
6. Ensures that performance of the coding staff meets or exceeds performance standards to ensure maximized and timely reimbursement of services.
7. Writes and maintains departmental processes and reference guides to ensure correct coding standards and effective timely claims processing.
8. Performs periodic coding and charge audits to ensure compliance with insurance rules and regulations and summarizes and presents findings to appropriate personnel.
9. Maintains proper coding database for reimbursement measurement.

Standard Management Level Responsibilities:

1. Directs and supervises assigned personnel including performance evaluations scheduling orientation and training. Makes recommendations on employee hires transfers promotions salary changes discipline terminations and similar actions. Resolves grievances and other personnel problems within position responsibilities.
2. Develops and recommends the budgets for the areas managed. Manages activities to assure financial goals are met.
3. Coordinates the assignment of tasks and helps resolve technical and operational problems. Evaluates the impact of solutions to ensure goals are achieved.
4. Provides effective direction guidance and leadership over the staff for effective teamwork and motivation and fosters the effective integration of efforts with system-wide initiatives.
5. Encourages and supports diverse views and approaches demonstrates Standards of Respect and contributes to creating and maintaining an environment of professionalism respect tolerance civility and acceptance toward all employees patients and visitors.
6. Integrates diversity into departmental objectives such as hiring promotions training vendor selections etc.
7. Participates in performance improvement initiatives and demonstrates the use of quality improvement in daily operations.
8. Ensures compliance with regulatory agencies such as Joint Commission DPH etc. Develops and maintains procedures necessary to meet regulatory requirements.
9. Ensures that department complies with hospital established policies quality assurance programs safety and infection control policies and procedures.
10. Ensures adequate equipment and supplies for department.
11. Develops and maintains established departmental policies procedures and objectives.
12. Ensures compliance to all health and safety regulations and requirements.
13. Maintains regular reliable and predictable attendance.
14. Performs similar or related duties as required or directed.

All responsibilities are essential job functions.

II. Position Qualifications:

License/Certification/Education:
Required:
1. Bachelors degree and 7-10 years of Healthcare experience required.

Experience/Skills:
Required:
1. Five years of coding experience and certification in physician-based coding.
2. Minimum of 4 years managerial experience within a physician billing setting required.
3. Demonstrated leadership ability initiative teamwork and assertiveness.
4. Excellent verbal written and interpersonal communication skills.
5. Computer skills and ability to access and use multiple data systems including various PC applications e.g. Excel Word Access and Power Point.
6. Extensive knowledge in ICD and CPT coding 3rd party payer requirements and federal and state guidelines and regulations pertaining to coding and billing practices.
7. Proven analytical research and evaluation skills required to make recommendations and implement operational improvement strategies as part of a cohesive team.
8. Ability to effectively interact with various people and adhere to team management concepts.
9. Must maintain current knowledge of coding and billing practices through reading of newsletters publications and attendance at seminars.
10. Must have the ability to maintain a positive attitude and professional manner when interacting with team members management and other staff members.

Unless certification licensure or registration is required an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Department-specific competencies including age-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

III. Physical Demands and Environmental Conditions:

Position is primarily sedentary with occasional standing and walking required. Position requires frequent use of computer and therefore requires being able to use keyboard printer and reading of developed material. Position requires work indoors in normal office environment.

All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or protected veteran status.

Were striving to make respect a part of everything we do at UMass Memorial Health for our patients our community and each other. Our six Standards of Respect are: Acknowledge Listen Communicate Be Responsive Be a Team Player and Be Kind. If you share these Standards of Respect we hope you will join our team and help us make respect our standard for everyone every day.

As an equal opportunity and affirmative action employer UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race color religion gender sexual orientation national origin age disability gender identity and expression protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability please contact us at We will make every effort to respond to your request for disability assistance as soon as possible.