Coding Specialist III

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Exemption Status:

Schedule Details:

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This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

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 16,000 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.

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.

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.

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.

Department-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.

III. Physical Demands and Environmental Conditions:

Work is considered sedentary. Position requires work indoors in a normal office environment.

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.