Coding/Billing Compliance Analyst

Site: Mass General Brigham Incorporated

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Summary

Responsible to analyze and audit medical coding and billing processes to identify potential compliance issues, discrepancies, and opportunities for improvement.

Essential Functions

-Conduct comprehensive audits of medical coding, billing, and documentation practices to assess compliance with industry regulations and internal policies.

-Monitor coding and billing practices on an ongoing basis to identify trends, patterns, and potential compliance risks.

-Stay updated on changes in coding and billing regulations, including those from CMS, CPT, and other governing bodies, to ensure compliance.

-Review medical documentation to ensure alignment with billed services and coding specificity requirements.

-Evaluate the accuracy and appropriateness of diagnostic and procedural codes assigned to medical services.

Qualifications

• Bachelor's Degree in Health Information Management or related field of study required
• 2-3 years of experience preferred in medical coding, billing, compliance auditing, or a related role within the healthcare industry

Knowledge, Skills and Abilities

• In-depth knowledge of coding systems (ICD-10, CPT, HCPCS) and billing guidelines, as well as compliance regulations related to healthcare billing and coding.
• Analytical and critical thinking skills to conduct audits and identify compliance issues.
• Excellent written and verbal communication skills to effectively communicate compliance findings and recommendations.
• Attention to detail and the ability to work independently and collaboratively in a team-oriented environment.
• Proficiency in using healthcare software applications and electronic health record (EHR) systems.

Additional Job Details (if applicable)

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$62,400.00 - $90,750.40/Annual

Grade

6

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.