Mass General Brigham
- Charlestown, MA
- Permanent
- Full-time
To be effective in this function, the Sr. Expert needs to have a working understanding of Medicare requirements, consisting of coding, medical record documents and billing requirements and a capability to successfully research study requirements and finish an applicability and effect analysis. Effective prospects need to have the ability to comprehend, use and analyze intricate billing guidelines in a range of treatment settings and healthcare-related federal government policies, consisting of Medicare and Medicaid. Medical understanding, analytical and important thinking abilities are needed to perform compliance audits and draft reports. Work is carried out in a group environment with direct guidance by the Compliance Coding/Billing Manager, for that reason strong partnership and interaction abilities are necessary.
The responsibilities of the Sr. Expert will consist of the efficiency of audits relating to outpatient CPT project, evaluation of modifier use, charge capture and billing activities. The Sr. Expert might likewise act as department topic professional for regulative compliance coding and billing by participating in conferences and/or helping the Manager of Coding and Billing Compliance in the advancement of coding compliance education products. The Sr. Expert will provide an individual example of principles and compliance, promote a culture of compliance throughout the company, and work to reinforce the Corporate and entity compliance programs.
Responsibilities:
- Execution of coding and billing audits in accordance with the Department’s yearly work strategy and requirements.
- Work collaboratively with Manager of Coding and Billing Compliance and other staff member to determine and evaluate coding and billing compliance threats.
- Maintain a working understanding of relevant regulative assistance and work as a subject specialist in coding and billing compliance as it associates with crucial locations such as CPT-4, HCPCS, ICD-9 CM and ICD-10 coding in addition to payer-specific standards.
- Ability to successfully and effectively research study coding and billing assistance.
- Assist coding and client accounting departments in fixing rejections or mistake line rejections.
- Work carefully with staff members at all levels of Partners and Affiliate entities to promote a culture of compliance and enhance the compliance program.
- Communicate with colleagues utilizing a high level of professionalism and a customer care orientation.
- Demonstrate professionalism and service quality in all undertakings.
- Present at all times an individual example of ethical and certified habits.
- Maintain privacy and discretion concerning all work matters.
- Demonstrate exceptional work principles and work cooperatively with all employee and customers with a can-do spirit and group mindset.
- Assist in unique jobs as required
About United States
As a not-for-profit company, Partners HealthCare is dedicated to supporting client care, research study, mentor, and service to the neighborhood by leading development throughout our system. Established by Brigham and Women’s Hospital and Massachusetts General Hospital, Partners HealthCare supports a total continuum of care consisting of neighborhood and specialized medical facilities, a handled care company, a doctor network, neighborhood university hospital, house care and other health-related entities. Numerous of our medical facilities are teaching affiliates of Harvard Medical School, and our system is a nationwide leader in biomedical research study.
We’re concentrated on a people-first culture for our system’s clients and our expert household. That’s why we supply our workers with more methods to accomplish their capacity. Partners HealthCare is dedicated to aligning our workers’ individual goals with jobs that match their abilities and developing a culture that empowers our supervisors to end up being relied on coaches. We support each member of our group to own their individual advancement– and we acknowledge success at every action.
Our staff members utilize the Partners HealthCare worths to govern choices, actions and habits. These worths direct how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we deal with each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.
Qualifications
- Associate or bachelor’s degree in a health science occupation or similar education chosen
- Procedural, diagnostic coding accreditation through American Health Information Management Association (AHIMA) Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS) or Certified Coding Specialist– Physician-based (CCS-P) or American Academy of Procedural Coders, Certified Professional Coder (CPC) or Certified Professional Coder-Hospital (CPC-H) needed in practice location, AHIMA accreditation chosen over AAPC accreditation
- Minimum 3 years of CPT-4 coding and/or experience in addition to understanding of assessment and management coding needed, 2-3 years of compliance coding/billing auditing chosen, ICD-10 coding experience chosen
- Knowledge of Medicare medical facility and doctor compensation approaches and associated profits cycle procedures, consisting of experience evaluating and analyzing coding and billing protection files
- Experience with electronic medical record systems (EMR) and extensive understanding and understanding of system documents and coding procedures. Impressive experience chosen
- Strong organizational, analytical, crucial thinking and inspirational abilities needed.
- Proficient with spreadsheet (Excel) and data processing software application.
- Ability to successfully interact (composed and verbally).
- Self-motivated and have the capability to work well with customers, leaders, and associates
Mass General Brigham
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