Coding Specialist III, Physician Billing

UMass Memorial Health•Worcester, MA

8h•$26 - $38

About The Position

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 20,000 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. Responsible for interpreting medical record data in order to process physician and/or facility charges. Assigns appropriate ICD-CM (current edition), CPT codes and modifiers as appropriate. Coordinates and performs work of assigned Coding Specialists and monitors progress and work quality. Trains employees, provides employee performance data, and fosters process improvements.

Requirements

High School education, plus medical coding certification and training in medical terminology from an accredited program. Recognized programs include: AHIMA, NHA, and AAPC.
Five years of medical abstraction and coding experience or related work experience.
Knowledge of ICD-CM (current edition) and CPT HCPCS coding systems, 3rd party payer requirements and federal/state guidelines and regulations pertaining to coding and billing practices.
The ability to lead, organize, and support the work of less senior Coding Specialists is a primary function of this position.
Requires good interpersonal and communications skills and maintains a professional manner when working with team members, management and other staff members.
Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word.

Responsibilities

Distributes and monitors the flow of work for coding staff. Provides training and technical assistance to employees within the assigned work area. Assists supervisor in ensuring that assigned employees are provided with appropriate resources, materials, and methods. Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel. Relays work instruction from the supervisor. Reviews coded records for coding quality assurance. Provides instruction and feedback to coding staff regarding proper coding assignment as necessary.
Acts as a point person/department resource for special projects/programs and responds to coding related questions and issues.
Assists in MD, Resident and Nursing documentation reviews, audits, and educational sessions as applicable.
Performs analysis on medical record documentation to include review of tests/reports, and determines appropriate codes, as defined by coding guidelines and other recognized reference materials.
Abstracts and enters all codes and required demographic information into the UMMHC computer system and/or onto encounter forms.
Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.
Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.
Participates in quality assurance and performance measurement reviews and reporting.
Communicates to supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner.
Informs management of any coding irregularities or trends contrary to policy or procedure, and communicates with clinical staff if necessary and appropriate.
Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.