Top 3 Manager encoder operations Jobs in Somerville, Ma

Inpatient Coding Quality & Education Specialist
Mass General Brigham Incorporated —Somerville, MA
- $63,648.00 - $92,570.40 a year
- Full-time
- Project management
- Travel
- Mentoring
- Opportunities for advancement
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manager encoder operations jobs near somerville, ma

Inpatient Coding Quality & Education Specialist

Mass General Brigham Incorporated -
Somerville, MA

Quick Apply

Job Details

Full-time
$63,648.00 - $92,570.40 a year
8 days ago

Benefits

Opportunities for advancement

Qualifications

Healthcare onboarding training
Employee onboarding
Inpatient experience
Medical software
Mentoring
Developing training programs for medical billing and coding teams
Health information management
Quality audits
Onboarding process management
Associate's degree
DRG
Quality assurance experience within healthcare

Full Job Description

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

About Us:
As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women’s Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

We’re focused on a people-first culture for our system’s patients and our professional family. That’s why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees’ personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development—and we recognize success at every step.

Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.

Qualifications

Position Summary

The Inpatient Coding Quality & Education Specialist serves as a subject matter expert in ICD-10-CM/PCS coding, coding quality, clinical data integrity, and coding-related performance improvement initiatives. This role supports organizational goals related to coding accuracy, quality outcomes, reimbursement integrity, compliance, and operational efficiency through coder education, auditing, onboarding, data analysis, and collaboration with multidisciplinary stakeholders.

The specialist partners closely with Coding Operations, Coding Quality, Clinical Documentation Integrity (CDI), Revenue Integrity, Quality, and other operational teams to identify trends, develop educational strategies, improve coding workflows, and support quality reporting methodologies including Vizient, Elixhauser, mortality, severity of illness (SOI), risk of mortality (ROM), expected length of stay, and other coding-sensitive measures.

Key Responsibilities

Coding Quality & Audit Activities

Perform pre-bill and post-bill coding audits utilizing internal and third-party audit platforms and vendor software.
Review coded accounts for coding accuracy, reimbursement integrity, quality reporting implications, and compliance with coding guidelines.
Analyze audit findings to identify trends, educational opportunities, and systemic process improvement initiatives.
Collaborate with Coding Operations, Quality, CDI, Revenue Integrity, and Compliance teams to address identified findings and implement corrective actions.
Track, trend, and report audit outcomes to leadership and operational stakeholders.
Support external audit preparedness and validation activities, including payer, regulatory, and vendor reviews.

Education & Training

Lead onboarding and competency development for newly hired inpatient coders or Data Quality Specialist.
Develop and deliver coding education related to ICD-10-CM, ICD-10-PCS, Official Coding Guidelines, Coding Clinic advice, regulatory updates, and organizational policies.
Create educational materials, tip sheets, job aids, presentations, and learning resources.
Facilitate individual and group education sessions based on audit findings, quality trends, and operational needs.
Support ongoing professional development and coding competency initiatives.

Quality & Clinical Data Integrity Support

Collaborate with quality, CDI, and operational teams to evaluate coding impacts on quality reporting and benchmarking methodologies.
Analyze coding opportunities affecting Vizient, Elixhauser, mortality, severity of illness, risk of mortality, expected length of stay, patient safety indicators, hospital-acquired conditions, and other coding-sensitive measures.
Assist in identifying opportunities to improve data integrity through accurate code assignment and documentation interpretation.
Support coding-related initiatives that impact organizational quality performance and external reporting.

Operational Improvement & Workflow Optimization

Partner with Coding Operations and leadership to identify workflow efficiencies and process improvement opportunities.
Provide recommendations regarding coding work queues, system edits, automation opportunities, workflow design, and operational controls.
Assist in developing and monitoring coding quality metrics, dashboards, and performance indicators.
Participate in enterprise projects related to coding quality, compliance, education, and operational effectiveness.
Evaluate trends and provide recommendations to improve productivity, accuracy, and consistency.

Leadership Support & Consultation

Serve as a coding subject matter expert for inpatient coding-related questions and initiatives.
Provide consultative support to leadership regarding coding trends, audit findings, education needs, and performance improvement opportunities.
Assist leaders with action planning, performance monitoring, and implementation of corrective actions when appropriate.
Support organizational readiness for coding guideline updates, regulatory changes, and system implementations.

Compliance & Regulatory Support

Promote adherence to Official Coding Guidelines, Coding Clinic guidance, payer requirements, and organizational policies.
Assist with coding compliance reviews and remediation activities.
Maintain current knowledge of regulatory changes, coding updates, and industry best practices.
Support audit preparedness and coding compliance initiatives across the organization.

Required Qualifications

Associate's degree in Health Information Management or related field (Bachelor's preferred)
RHIA, RHIT, CCS, or equivalent credential required
5 years of progressively responsible inpatient coding experience
2 years of coding quality, auditing, education, mentoring, or leadership experience
Advanced knowledge of ICD-10-CM/PCS, MS-DRG assignment, Official Coding Guidelines, Coding Clinic, and reimbursement methodologies

Preferred

7–10 years of inpatient coding experience
Experience onboarding and mentoring coders
Experience conducting coding audits and developing education plans
Experience supporting quality reporting methodologies (Vizient, Elixhauser, PSI/HAC, SOI/ROM, mortality, expected LOS)
Experience with Epic, Solventum/3M, encoder and auditing platforms
Lean, process improvement, or project management experience

Working Conditions:

Extensive use of computer equipment and software
Frequent interaction with staff across all levels of the organization
Low physical effort
Occasional bending, stooping, kneeling, crouching and/or reaching.
Remote workers considered but may require limited travel to corporate office.

Additional Job Details (if applicable)

Remote Type

Remote

Work Location

399 Revolution Drive

Scheduled Weekly Hours

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$63,648.00 - $92,570.40/Annual

Grade

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:

0100 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.

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Position Summary

Key Responsibilities

Coding Quality & Audit Activities

Perform pre-bill and post-bill coding audits utilizing internal and third-party audit platforms and vendor software.

Review coded accounts for coding accuracy, reimbursement integrity, quality reporting implications, and compliance with coding guidelines.

Analyze audit findings to identify trends, educational opportunities, and systemic process improvement initiatives.

Collaborate with Coding Operations, Quality, CDI, Revenue Integrity, and Compliance teams to address identified findings and implement corrective actions.

Track, trend, and report audit outcomes to leadership and operational stakeholders.

Support external audit preparedness and validation activities, including payer, regulatory, and vendor reviews.

Education & Training

Lead onboarding and competency development for newly hired inpatient coders or Data Quality Specialist.

Develop and deliver coding education related to ICD-10-CM, ICD-10-PCS, Official Coding Guidelines, Coding Clinic advice, regulatory updates, and organizational policies.

Create educational materials, tip sheets, job aids, presentations, and learning resources.

Facilitate individual and group education sessions based on audit findings, quality trends, and operational needs.

Support ongoing professional development and coding competency initiatives.

Quality & Clinical Data Integrity Support

Collaborate with quality, CDI, and operational teams to evaluate coding impacts on quality reporting and benchmarking methodologies.

Analyze coding opportunities affecting Vizient, Elixhauser, mortality, severity of illness, risk of mortality, expected length of stay, patient safety indicators, hospital-acquired conditions, and other coding-sensitive measures.

Assist in identifying opportunities to improve data integrity through accurate code assignment and documentation interpretation.

Support coding-related initiatives that impact organizational quality performance and external reporting.

Operational Improvement & Workflow Optimization

Partner with Coding Operations and leadership to identify workflow efficiencies and process improvement opportunities.

Provide recommendations regarding coding work queues, system edits, automation opportunities, workflow design, and operational controls.

Assist in developing and monitoring coding quality metrics, dashboards, and performance indicators.

Participate in enterprise projects related to coding quality, compliance, education, and operational effectiveness.

Evaluate trends and provide recommendations to improve productivity, accuracy, and consistency.

Leadership Support & Consultation

Serve as a coding subject matter expert for inpatient coding-related questions and initiatives.

Provide consultative support to leadership regarding coding trends, audit findings, education needs, and performance improvement opportunities.

Assist leaders with action planning, performance monitoring, and implementation of corrective actions when appropriate.

Support organizational readiness for coding guideline updates, regulatory changes, and system implementations.

Compliance & Regulatory Support

Promote adherence to Official Coding Guidelines, Coding Clinic guidance, payer requirements, and organizational policies.

Assist with coding compliance reviews and remediation activities.

Maintain current knowledge of regulatory changes, coding updates, and industry best practices.

Support audit preparedness and coding compliance initiatives across the organization.

Required Qualifications

Associate's degree in Health Information Management or related field (Bachelor's preferred)

RHIA, RHIT, CCS, or equivalent credential required

5 years of progressively responsible inpatient coding experience

2 years of coding quality, auditing, education, mentoring, or leadership experience

Advanced knowledge of ICD-10-CM/PCS, MS-DRG assignment, Official Coding Guidelines, Coding Clinic, and reimbursement methodologies

Preferred

7–10 years of inpatient coding experience

Experience onboarding and mentoring coders

Experience conducting coding audits and developing education plans

Experience supporting quality reporting methodologies (Vizient, Elixhauser, PSI/HAC, SOI/ROM, mortality, expected LOS)

Experience with Epic, Solventum/3M, encoder and auditing platforms

Lean, process improvement, or project management experience

Working Conditions:

Extensive use of computer equipment and software

Frequent interaction with staff across all levels of the organization

Low physical effort

Occasional bending, stooping, kneeling, crouching and/or reaching.

Remote workers considered but may require limited travel to corporate office.

Mass General Brigham Competency Framework