Job Details

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Exemption Status: Non-Exempt

Schedule Details: Monday through Friday

Scheduled Hours: 7:00am-3:30pm

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.

Major Responsibilities

1. Reviews coded medical records for coding quality assurance. Provides instruction and feedback to coding staff regarding proper coding as necessary.
2. Analyzes medical record documentation, including review of tests and reports, and assigns appropriate ICD CM (current edition) primary and secondary diagnoses and procedure codes according to Official Coding Guidelines. Utilizes CPT 4 and HCPCS classification systems as required.
3. Abstracts and enters all codes into the hospital computer system.
4. Distributes and monitors the flow of work for coding staff. Provides training and technical assistance to employees within the assigned work area. Assists manager in assuring 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 manager.
5. Alerts management to any coding irregularities, or trends contrary to policy/procedure, so that corrective measures can be taken.
6. Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.
7. Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.

Standard Staffing Level Responsibilities

1. Complies with established departmental policies, procedures and objectives.
2. Attends variety of meetings, conferences, seminars as required or directed.
3. Demonstrates use of Quality Improvement in daily operations.
4. Complies with all health and safety regulations and requirements.
5. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
6. Maintains, regular, reliable, and predictable attendance.
7. Performs other similar and related duties as required or directed.

All responsibilities are essential job functions.

Position Qualifications

License/Certification/Education: Required: Level of knowledge equivalent to an Associate or bachelor's degree in Health Information Management, and an AHIMA certification; Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) or Certified Coding Specialist - Physician (CCS-P), is required. Certifications from the NHA, AAPC, or other professional Coding associations will be considered.

Experience/Skills: Required: Knowledge of ICD-CM (current edition) and CPT-4 HCPCS coding systems, 3rd party payer requirements and federal/state guidelines and regulations pertaining to coding and billing practices required. Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word. Requires good interpersonal and communications skills and demonstrates professionalism when working with team members, management and other staff members. Demonstrated leadership ability required. The ability to lead, organize, and support the work of the coding specialists is a primary function of this position. Ability to problem-solve, and to organize and prioritize work to meet strict deadlines.

Preferred: Five years of medical abstraction and coding experience or related work experience.

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.

Department-specific competencies, including age-specific competencies, and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

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 are committed to respect in all we do at UMass Memorial Health. 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 ...@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.