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Coding Specialist II, Physician Billing

Key Facts

Remote From: 
Full time
Mid-level (2-5 years)
English

Other Skills

  • Microsoft Excel
  • Quality Assurance
  • Microsoft Word
  • Computer Literacy
  • Social Skills
  • Professionalism
  • Teamwork
  • Communication

Roles & Responsibilities

  • High School education plus medical coding certification.
  • Training in medical terminology from an accredited program (AHIMA, NHA, or AAPC preferred).
  • Three years of medical abstraction and coding experience or related work experience; knowledge of ICD-CM (current edition), CPT, HCPCS coding systems.
  • Intermediate computer skills with ability to use Microsoft Office (Excel and Word) and strong interpersonal and communication skills.

Requirements:

  • Interpret medical record data to determine appropriate codes (ICD-CM, CPT) and modifiers per coding guidelines.
  • Abstract and enter all codes and required demographic information into the hospital system or abstracting database; assist with incomplete or missing chart documentation.
  • Participate in improvement efforts, documentation training for medical/clinical staff, and quality assurance/performance measurement reviews.
  • Maintain direct and ongoing communications with other coding and billing personnel to maximize operation effectiveness and alert management to backlogs or coding irregularities.

Job description

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

Exemption Status:

Non-Exempt

Hiring Range:

$23.24 - $39.28

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:

7am-3:30pm

Shift:

1 - Day Shift, 10 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) and CPT codes and modifiers as appropriate.

Individual Departments, (Emergency Medicine, Trauma Center, Endoscopy Suite, PBCBO, HIM, etc.) will have unique procedures, processes and/or focus, so responsibilities and tasks can differ depending on departmental needs. However, many of the core tasks, required experience and qualifications are similar among all Coding Specialists.

I. Major Responsibilities: 

1. 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. 
2. Abstracts and enters all codes and required demographic information into the UMMHC computer system, the hospital’s abstracting database, or onto encounter forms, where necessary.  
3. Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.
4. May participate in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.
5. May participate in quality assurance and performance measurement reviews and reporting.
6. Informs supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner.
7. Alerts management to any coding irregularities or trends contrary to policy/procedure so that corrective measures can be taken.
8. Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.
9. Completes patient’s abstracts mandated by Federal and State regulatory agencies, Physician Peer Review, and hospital planning for optimal facility utilization (i.e. Determination of Need, Quality Assurance, research studies and Utilization Review Program).

II. Position Qualifications:

License/Certification/Education:
Required:
1. High School education, plus medical coding certification. 


Preferred:
1. Training in medical terminology from an accredited program. Recognized programs include: AHIMA, NHA, and AAPC.

Experience/Skills:
Required:
1. Three 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. Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word.
4. Requires good interpersonal and communications skills and demonstrates professionalism when working with team members, management and other staff members.

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.

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