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
Under the general supervision of the Senior Coding Manager the Technical Advisor oversees, reviews and advised on the integrity of the ambulatory surgery coding/charging programs for the Mass General Brigham (MGB) Coding Department. The Technical Advisor advises on external/internal coding reviews and audits, new coding regulations impacts, coding and billing interlinking billing issues, coding education and workflow training for inpatient coding, claim edits and denials related to inpatient. Technical Advisor assists on the MGB Coding and Revenue Cycle-wide projects as needed. Technical Advisor assists on writing policies and procedures; coding system implementation projects; and coding education in their area of expertise. Will work very closely with multiple levels of Coding leadership, Technical Advisors, Data Quality Specialists, Coders and Clinical Documentation Improvement team to ensure an efficient and accurate coding program.
Education
High School Diploma required and Completion of a Coding Certificate program or Health Information Technology Program
3+ years of experience equivalent required in lieu of degree
AS/BS in Health Information Technology/Administration or related healthcare administration program preferred.
ICD-10-CM and CPT education required for both the Hospital and Professional coding.
Experience
Knowledge, Skills and Abilities
In-depth knowledge of coding systems, such as ICD-10-CM, CPT, and HCPCS, as well as familiarity with coding guidelines and regulations (e.g., HIPAA, HITECH Act).
Strong analytical and problem-solving skills, with the ability to review complex medical records and identify coding errors or inconsistencies.
Excellent communication and interpersonal skills, with the ability to collaborate effectively with multidisciplinary teams and healthcare professionals.
Proficiency in using coding software and electronic health record (EHR) systems.
Detail-oriented mindset and ability to work in a fast-paced environment, meeting deadlines and managing multiple priorities.
Up-to-date knowledge of industry trends, emerging technologies, and regulatory changes related to clinical coding.
Principal Duties and Responsibilities
Provides data and support to the overall coding compliance and audit program. Provides data needed to update staff, Senior Leadership and entity partners regarding audit findings and action plans as well as coding related regulatory changes and impacts.
Assists in the development and revision of program policies and procedures and internal guidance documents.
Recommends updates to the Coding Compliance manual.
Works closely with coding management and Data Quality Specialists in developing criteria and evaluating the quality of coding provided by the program.
Provides program related SME liaison as needed with entity CDI and quality teams. Serves on entity and enterprise committees as required.
Ensures that all audit, compliance and educational activities are appropriately documented.
Assists as SME in all aspects of internal and external coding audit activities providing root cause analysis and recommendations based on trends in findings.
Assists with development, implementation and management of program education materials and notifications to staff.
Recommends and/or provides coder education as required based on audit findings.
Participates and/or facilitates staff meetings as required.
Assists CDI teams in providing specialty-based documentation improvement education as required.
Works closely with corporate and entity Audit and Compliance teams as required.
Keeps abreast of all developments in the coding, audit and compliance field and continues to improve leadership and management skills through participation in professional activities, continuing education and other related activates.
Supports Claim edits, denials and customer service inquiries as peer reviewer.
SME to internal departments (Vendor Management) – such as responding to vendor questions, WQ surveillance.
Other duties as assigned by the Coding Operations Manager or Management Team.
Additional Job Details (if applicable)
Remote
399 Revolution Drive
40
Regular
Day (United States of America)
Pay Range
$62,400.00 - $90,750.40/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 package. In 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.
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 Veteran’s 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 (857)-282-7642.
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.
