Inpatient Coding Quality & Education Specialist

Site: Mass General Brigham Incorporated

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

About Us:
As a not-for-profit organization Mass General Brigham is committed to supporting patient care research teaching and service to the community by leading innovation across our system. Founded by Brigham and Womens Hospital and Massachusetts General Hospital Mass General Brigham supports a complete continuum of care including community and specialty hospitals a managed care organization a physician network community health centers home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School and our system is a national leader in biomedical research.

Were focused on a people-first culture for our systems patients and our professional family. Thats why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal developmentand we recognize success at every step.

Our employees use the Mass General Brigham values to govern decisions actions and behaviors. These values guide how we get our work done: Patients Affordability Accountability & Service Commitment Decisiveness Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion Integrity & Respect Learning Continuous Improvement & Personal Growth Teamwork & Collaboration.

Position Summary

The Inpatient Coding Quality & Education Specialist serves as a subject matter expert in ICD-10-CM/PCS coding coding quality clinical data integrity and coding-related performance improvement initiatives. This role supports organizational goals related to coding accuracy quality outcomes reimbursement integrity compliance and operational efficiency through coder education auditing onboarding data analysis and collaboration with multidisciplinary stakeholders.

The specialist partners closely with Coding Operations Coding Quality Clinical Documentation Integrity (CDI) Revenue Integrity Quality and other operational teams to identify trends develop educational strategies improve coding workflows and support quality reporting methodologies including Vizient Elixhauser mortality severity of illness (SOI) risk of mortality (ROM) expected length of stay and other coding-sensitive measures.

Key Responsibilities

Coding Quality & Audit Activities

• Perform pre-bill and post-bill coding audits utilizing internal and third-party audit platforms and vendor software.

• Review coded accounts for coding accuracy reimbursement integrity quality reporting implications and compliance with coding guidelines.

• Analyze audit findings to identify trends educational opportunities and systemic process improvement initiatives.

• Collaborate with Coding Operations Quality CDI Revenue Integrity and Compliance teams to address identified findings and implement corrective actions.

• Track trend and report audit outcomes to leadership and operational stakeholders.

• Support external audit preparedness and validation activities including payer regulatory and vendor reviews.

Education & Training

• Lead onboarding and competency development for newly hired inpatient coders or Data Quality Specialist.

• Develop and deliver coding education related to ICD-10-CM ICD-10-PCS Official Coding Guidelines Coding Clinic advice regulatory updates and organizational policies.

• Create educational materials tip sheets job aids presentations and learning resources.

• Facilitate individual and group education sessions based on audit findings quality trends and operational needs.

• Support ongoing professional development and coding competency initiatives.

Quality & Clinical Data Integrity Support

• Collaborate with quality CDI and operational teams to evaluate coding impacts on quality reporting and benchmarking methodologies.

• Analyze coding opportunities affecting Vizient Elixhauser mortality severity of illness risk of mortality expected length of stay patient safety indicators hospital-acquired conditions and other coding-sensitive measures.

• Assist in identifying opportunities to improve data integrity through accurate code assignment and documentation interpretation.

• Support coding-related initiatives that impact organizational quality performance and external reporting.

Operational Improvement & Workflow Optimization

• Partner with Coding Operations and leadership to identify workflow efficiencies and process improvement opportunities.

• Provide recommendations regarding coding work queues system edits automation opportunities workflow design and operational controls.

• Assist in developing and monitoring coding quality metrics dashboards and performance indicators.

• Participate in enterprise projects related to coding quality compliance education and operational effectiveness.

• Evaluate trends and provide recommendations to improve productivity accuracy and consistency.

Leadership Support & Consultation

• Serve as a coding subject matter expert for inpatient coding-related questions and initiatives.

• Provide consultative support to leadership regarding coding trends audit findings education needs and performance improvement opportunities.

• Assist leaders with action planning performance monitoring and implementation of corrective actions when appropriate.

• Support organizational readiness for coding guideline updates regulatory changes and system implementations.

Compliance & Regulatory Support

• Promote adherence to Official Coding Guidelines Coding Clinic guidance payer requirements and organizational policies.

• Assist with coding compliance reviews and remediation activities.

• Maintain current knowledge of regulatory changes coding updates and industry best practices.

• Support audit preparedness and coding compliance initiatives across the organization.

Required Qualifications

• Associates degree in Health Information Management or related field (Bachelors preferred)

• RHIA RHIT CCS or equivalent credential required

• 5 years of progressively responsible inpatient coding experience

• 2 years of coding quality auditing education mentoring or leadership experience

• Advanced knowledge of ICD-10-CM/PCS MS-DRG assignment Official Coding Guidelines Coding Clinic and reimbursement methodologies

Preferred

• 710 years of inpatient coding experience

• Experience onboarding and mentoring coders

• Experience conducting coding audits and developing education plans

• Experience supporting quality reporting methodologies (Vizient Elixhauser PSI/HAC SOI/ROM mortality expected LOS)

• Experience with Epic Solventum/3M encoder and auditing platforms

• Lean process improvement or project management experience

Working Conditions:

• Extensive use of computer equipment and software

• Frequent interaction with staff across all levels of the organization

• Low physical effort

• Occasional bending stooping kneeling crouching and/or reaching.

• Remote workers considered but may require limited travel to corporate office.

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$63648.00 - $92570.40/Annual

Grade

6

At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

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