Coding QA Specialist

Summary

Mass General Brigham is a not-for-profit healthcare organization supporting patient care, research, teaching, and community service. The Coding QA Specialist ensures the accuracy and quality of surgical billing and coding information by conducting audits, correcting documentation errors, monitoring performance, and reporting findings and improvement opportunities.

Responsibilities

• Completing regular audits, summarizing and reporting audit results, and recommending preventative actions when errors occur
• Identifies and corrects errors in records, ensuring proper documentation and adherence to practices
• Identify opportunities for additional training and/or enhancements to training materials and work collaboratively with internal and external teams to help provide education and training in these areas
• Assist with the development and delivery of regular reports on performance, trends, and other actionable insights to the QA, Training, and Operations Leadership teams
• Document evaluations utilizing departmental quality monitoring templates, established quality standards, and quality monitoring technology
• Develops and maintains quality assurance reports, tracking performance metrics, and identifying areas for improvement
• Regularly and accurately report findings to the Manager and/or user via the approved scoring, tracking, and reporting mechanisms

Skills

• Associate's Degree Healthcare Administration/ related field required
• CPC required
• Thorough knowledge of coding standards and clinical documentation requirements
• Strong analytical and problem-solving skills
• Excellent communication skills, with the ability to provide constructive feedback
• Attention to detail and commitment to maintaining high-quality standards
• Ability to work independently and manage multiple tasks simultaneously
• Bachelor's degree preferred
• CPMA, RHIA, RHIT, CHC preferred
• 5 Years of Surgical Coding experience preferred
• Experience In QA/auditing, 1-3 Years Preferred
• This position will be auditing for surgical coding. Experience in surgical coding is strongly preferred

Qualifications

Must Haves

• Associate's Degree Healthcare Administration/ related field required
• CPC required
• Thorough knowledge of coding standards and clinical documentation requirements
• Strong analytical and problem-solving skills
• Excellent communication skills, with the ability to provide constructive feedback
• Attention to detail and commitment to maintaining high-quality standards
• Ability to work independently and manage multiple tasks simultaneously

Nice to Haves

• Bachelor's degree preferred
• CPMA, RHIA, RHIT, CHC preferred
• 5 Years of Surgical Coding experience preferred
• Experience In QA/auditing, 1-3 Years Preferred
• This position will be auditing for surgical coding. Experience in surgical coding is strongly preferred

Benefits

• Remote work arrangement
• Comprehensive benefits
• Career advancement opportunities
• Differentials
• Premiums
• Bonuses as applicable
• Recognition programs designed to celebrate your contributions and support your professional growth