Learn more about working at New England Baptist Hospital
Medical Record Coder
Boston, Massachusetts
Organization Facility: New England Baptist Hospital Category: Coding/Validation Job ID: JR13827 Date posted: 03/15/2023When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Job Type:
RegularScheduled Hours:
40Work Shift:
Day (United States of America)MEDICAL RECORD CODERJob Description:
PROFESSIONAL MEDICAL RECORDS CODER
Under the direction of the Professional Revenue Integrity Manager
Essential Tasks / Responsibilities
- Conducting focused compliance assessments of CPT/HCPCS and ICD code assignment
- Evaluating billed charge data and professional services claims (e.g. CMS-1500) for accuracy of claim reporting requirements
- Evaluating the adequacy of medical record documentation for professional services providers
- Preparing reports / audit results as required related to the specific auditing activities performed
- Analyzing coded data to assess billing patterns and identify potential aberrant billing patterns
- Analyzing claim denials and associated claim documentation to determine cause and potential resolution
- Providing recommendations to providers and management
- Developing and implementing processes that will effectively monitor/track compliance requirements, reporting, and performance metrics / scorecards etc.
- Interfacing with NEBH revenue cycle and third-party billing vendors, if applicable, to facilitate analysis and/or issue resolutions, as applicable
- Developing, conducting, and/or coordinating provider coding / documentation training including implementation and maintenance of provider training resources / references
- Conducting NEBMA, SPINE CTR & NEBMA Hospitalist group coding review and updating requests daily
- Fulfilling all medical note review requests (OPTUM, BCBS, etc.)
- Providing educational materials and coding accuracy to clinicians
- Analyzing billing company reports
Qualifications / Skills
- Strong reading comprehension skills
- Solid oral and written communication skills
- Native or Fluent proficiency in English language
- Excellent typing and 10-key speed and accuracy
- Strong knowledge of anatomy, physiology, and medical terminology
- Attention to detail, organization, and time management skills
- Microsoft Office skills (Outlook, Word, Excel, PowerPoint)
- Ability to work on numerous software applications systems and a willingness to learn
- Ability to work both independently and as a team player within a hybrid environment
Education, Experience, and Licensing Requirements
- High school diploma, GED, or equivalent required, university/college degree is a plus
- 1 year of medical coding experience required, 2+ years preferred
- CCS, CCS-P, CCA, CPC, COC, or CPC-A required
- Experience working in medical office and communicating with clinicians preferred
- Experience with medical billing and CMS-1500 forms preferred
- Experience using eClinicalWorks, Soarian, Medaptus, or Optum EncoderPro is a plus
FLSA Status:
Non-ExemptAs a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.
More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.
Equal Opportunity Employer/Veterans/Disabled
