Job Details

Everyone Is a Caregiver

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 20,000 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.

Responsible for interpreting medical record data in order to process physician and/or facility charges. Assigns appropriate ICD-CM (current edition) and CPT codes and modifiers as appropriate. Individual Departments, (Emergency Medicine, Trauma Center, Endoscopy Suite, PBCBO, HIM, etc.) will have unique procedures, processes and/or focus, so responsibilities and tasks can differ depending on departmental needs. However, many of the core tasks, required experience and qualifications are similar among all Coding Specialists.

I. Major Responsibilities:

1. 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.

2. Abstracts and enters all codes and required demographic information into the UMMHC computer system, the hospital's abstracting database, or onto encounter forms, where necessary.

3. Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.

4. May participate in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.

5. May participate in quality assurance and performance measurement reviews and reporting.

6. Informs supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner.

7. Alerts management to any coding irregularities or trends contrary to policy/procedure so that corrective measures can be taken.

8. Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.

9. Completes patient's abstracts mandated by Federal and State regulatory agencies, Physician Peer Review, and hospital planning for optimal facility utilization.

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.

II. Position Qualifications:

License/Certification/Education: Required: 1. High School education, plus medical coding certification.

Preferred: 1. Training in medical terminology from an accredited program. Recognized programs include: AHIMA, NHA, and AAPC.

Experience/Skills: Required: 1. Three 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. Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word. 4. Requires good interpersonal and communications skills and demonstrates professionalism when working with team members, management and other staff members.

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.