Certified Professional Coder – Health Information Mgmt- Fully Remote in Boston, MA

Certified Professional Coder - Health Information Mgmt- Fully Remote - Tufts Medicine - Boston, MA - work from home job Company: Tufts Medicine Job description: We’re saving lives, building careers, and reimagining healthcare. We can’t wait to grow alongside you. Job is fully remote Hours: Monday-Friday 8-5PM Company Description It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees. Job Description Under the direction of the Associate Director, reviews medical record documentation to identify pertinent diagnoses and/or procedures that require coding. The Certified Professional Coder reviews medical records to assure accurate specificity of diagnoses, procedures, and appropriate reimbursement for professional and/or facility charges. Effectively utilizes ICD-10, CPT, and HCPCS, modifier and/or other codes according to coding guidelines. Communicates effectively with providers and/or all appropriate staff regarding missing information such as CPT, ICD-10, and documentation issues, to ensure proper coding and reimbursement. Works with the Associate Director to review denial and reimbursement reports for accuracy, as well as conducting audits to ensure documentation, code capture, and billing are accurate and precise. Performs pre and post visit chart audits to ensure proper code assignment. PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS: Performs pre-visit chart audits, and post encounter review to ensure coding accuracy: • Is able to review medical records to ensure codes reported are support by the documentation • Reviews medical records for correct ICD-10, CPT, documentation and modifiers. • Is able to review reports with Associate Director to identify reimbursement changes/discrepancies. • Can assist with training of providers on proper coding and documentation Maintains a current and strong understanding of coding rules and CMS guidelines in the outpatient settings: • Is able to interpret and summarize ICD-10-CM and CPT coding changes, and updates • Incorporates changes to guidelines and regulations into audit practice • Researches and resolves coding and documentation regulatory issues • Is able to articulate coding and documentation guidelines changes to appropriate parties including, but not limited to providers. Reporting: • Review and work audit lists provided by Associate Director regarding coding/billing changes, as well as denial reports. • Identifies and evaluates coding issues, summarizes findings for leadership, makes recommendations for course of action Qualifications EDUCATION: • CPC required EXPERIENCE: • Minimum 2-5 years of outpatient coding, billing, primary care adult medicine and pediatric experience • Excellent organizational and interpersonal skills are essential as well as the ability to work on multiple tasks, to work under pressure, meet deadlines and provide excellent follow up. • Communication skills are essential. The ability to give oral presentations to staff as well as written skills to prepare reports for management. • The ability to work effectively as a member of a team is essential. • The ability to provide education and feedback to physicians on a regular basis in order to ensure CPT, ICD-10-CM, and Risk Adjustment guidelines are being met. WORKING CONDITIONS/PHYSICAL DEMANDS: • Working in an office and/or remote setting • Being available for in person and/or virtual meetings when needed. • Frequent contact with physicians and their office staff, insurance representative, medical directors, department heads and administrative managers. Tufts Medicine is a leading integrated health system bringing together the best of academic and community healthcare to deliver exceptional, connected and accessible care experiences to consumers across Massachusetts. Comprised of Tufts Medical Center, Lowell General Hospital, MelroseWakefield Hospital, Lawrence Memorial Hospital of Medford, Care at Home — an expansive home care network, and large integrated physician network. Please note that effective October 1, 2021, as a condition of employment at Tufts Medicine, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption. We are an equal opportunity employer and value diversity and inclusion at Tufts Medicine. Tufts Medicine does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided 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. Please contact us to request accommodation by emailing us at . Expected salary: Location: Boston, MA Job date: Thu, 17 Aug 2023 03:41:49 GMT Apply for the job now! Apply tot his job