Inpatient Coding Quality & Education Specialist

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.

 

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.

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