Coding Specialist III, Physician Billing at UMass Memorial Health – Worcester, Massachusetts

Position Title: Coding Specialist III, Physician Billing

Location: Worcester, MA Worcester Business Center

Time Type: Full time

Remote Type: Remote Caregivers (Primarily Remote)

Job Category: Finance

Job Family: Revenue Cycle

Job Type: Regular

Req ID: R26102600

Description:

Are you a current UMass Memorial Health caregiver? Apply now through Workday.

Exemption Status:
Non-Exempt

Hiring Range:
$25.83 - $38.36
Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule Details:
Monday through Friday

Scheduled Hours:
7:00am

Shift:
1 - Day Shift, 8 Hours (United States of America)

Hours:
40

Cost Center:
99940 - 5446 Professional Billing Coding

Union:
SHARE (State Healthcare and Research Employees)

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 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.

I. Major Responsibilities:

1. 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.
2. Acts as a point person/department resource for special projects/programs and responds to coding related questions and issues.
3. Assists in MD, Resident and Nursing documentation reviews, audits, and educational sessions as applicable.
4. 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.
5. Abstracts and enters all codes and required demographic information into the UMMHC computer system and/or onto encounter forms.
6. Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.
7. Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.
8. Participates in quality assurance and performance measurement reviews and reporting.
9. Communicates to supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner.
10. Informs management of any coding irregularities or trends contrary to policy or procedure, and communicates with clinical staff if necessary and appropriate.
11. Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.

II. Position Qualifications:

License/Certification/Education:
Required:
1. High School education, plus medical coding certification and training in medical terminology from an accredited program. Recognized programs include: AHIMA, NHA, and AAPC.

Experience/Skills:
Required:
1. Five years of medical abstraction and coding experience or related work experience.
2. 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.
3. The ability to lead, organize, and support the work of less senior Coding Specialists is a primary function of this position.
4. Requires good interpersonal and communications skills and maintains a professional manner when working with team members, management and other staff members.
5. Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word.

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.

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.

We’re 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 talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.

About Us:

At UMass Memorial Health, everyone is a caregiver. No matter their responsibilities or title, every employee or "caregiver" fills an important role for our patients and their families every day. Who is a caregiver? It's not just the person who delivers the care. It's all the people who make it work ... and make it better. Caregivers give everything that helps patients heal, from expertise to extra attention. They give clean, comfortable rooms. Fast, accurate answers. And an easier, less stressful experience. They give warm, reassuring smiles, and helping hands. We are more than 16,000 employees, working together as one health system in a relentless pursuit of healing for our patients, our community and each other. And everyone, in their own unique way, plays an important part, every day.