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Department Description: The Critical Care Auditor/ Coder position will be working directly with the Department of Anesthesia, Critical Care and Pain Medicine and will have the opportunity to work remotely following an initial onsite training period. The incumbent will be required from time-to-time to attend billing onsite staff meetings and meetings with the physicians they support. AFS, LLC is located in Needham Heights, Massachusetts. Job Location: Virtual Job Summary: Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement. Essential Responsibilities: • Analyzes evaluation and management, including critical care, procedures and other notes and documents to determine the scope and complexity of the services provided., • Utilizes professional coding knowledge, applies ICD10/CPT/HCPCs codes to the services delineated in the operative note., • Reviews documentation and codes to ensure appropriate capture of all billable services. Provides ongoing feedback and education to the applicable clinical staff regarding appropriate documentation and coding of services., • Interacts with physicians and other professional staff on documentation issues related to coding data., • Conducts coding review for medical policy and coding denials, while continually providing feedback to the department for clinical documentation improvement., • Remains current with any changes in ICD-10 and CPT-4 coding and remains current with Medicare, federal insurance and third-party billing compliance regulations. Works collaboratively with the Executive Director and coding management to ensure all the division charge tickets are compliant, accurate and updated annually or as new procedures are added to the division., • Maintains accurate and current codes in the system by working collaboratively with IS department. Maintains the department Practice and Procedure manual and updates quarterly with new or modified practices or procedures. Required Qualifications: 1. High School diploma or GED required., 2. Certificate 1 Certified Professional Coder required, CPMA preferred., 3. A MINIMUM of 5-7 years related work experience required., 4. Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis, and maintain databases. Competencies: 1. Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area., 2. Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents., 3. Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager., 4. Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers., 5. Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers., 6. Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations., 7. Teamwork: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments., 8. Customer Service: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations. Physical Nature of the Job: Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

Job Description POSITION SUMMARY As a Medical Biller at MASS LUNG & ALLERGY (MLA) this position performs a wide variety of duties and responsibilities in a manner that places emphasis on quality of care and customer service. The incumbent must work collaboratively with all staff in support of patient services, exhibiting flexibility and a "can-do" attitude. Patient services are the key priority in this position requiring the Medical Biller to serve as a point of contact with other internal and external departments, all with the goal of fostering an environment which promotes patient comfort and trust. The position must exemplify the core values and mission of the organization, always exercising utmost discretion, diplomacy, and tact in patient/staff interactions. 60% DUTIES AND RESPONSIBILITIES: • Register and verify insurances for inpatient/outpatient hospital, pulmonary function test readings, sleep study readings and nursing home claims., • Verifies completeness and accuracy of all claims prior to submission., • Referral and Authorization follow up, Insurance verification as necessary., • Transmit claims using billing software, including electronic and paper claim submissions., • Review and correct clearinghouse rejections as necessary., • Follow up on unpaid claims, investigate denials, resubmit corrected claims, appeals., • Patient Statements., • Patient Collections., • Collection's agency requests., • Returned mail., • ERA and EOB payment posting- including Zero pays, • Setting up patient payment plans and work collection accounts., • Running collection reports., • Provide patients with support and guidance as needed., • Attends staff and administrative meetings, as required., • Performs all duties and service in full compliance with MLA's Service Excellence Standards., • Performs all duties in support of successful EHR/EPM implementation., • Maintains workstation, according to protocols (free of meals and open beverages)., • Acts in capacity as an interpreter, only if certified to do so as needed., • Excellent written and verbal communication and problem-solving skills, • Intermediate computer skills- including but not limited to electronic medical records (EMR) software, Microsoft word and excel applications., • CPT and ICD-10 coding, familiarity with medical terminology, • Excellent customer service skills., • Demonstrates professionalism at all times., • Possess a thorough understanding of the importance of confidentiality and non-disclosure according to the general standards set forth by HIPAA., • Ability to manage relationships with various Insurance payers., • High school Graduate (or GED) required., • 2+ years' experience as a Medical Biller, • Certification Professional Coder, • Proficiency with electronic medical records (EMR), • Ability to work independently and collaboratively within a team environment

Job Description Job Title: Medical Record Billing Compliance Auditor Physician Educator Employer: Healthforce, Inc., a healthcare administrative services consulting firm, since 2015. Location: Primarily On-Site at Tewksbury Hospital, Tewksbury, Massachusetts (Massachusetts Department of Public Health Facility) with some remote work flexibility and occasional work at a secondary site. Job Description: We are seeking a Nationally Certified Medical Coder with a minimum of three years of experience as a Medical Record Billing Compliance Auditor and Medical Record Billing Compliance Physician Educator. The successful applicant will play a crucial role in ensuring the accuracy and compliance of our professional and facility billing claims. This position will primarily involve on-site work at Tewksbury Hospital in Tewksbury, MA, with some remote work flexibility. Key Responsibilities: • Perform comprehensive audits of professional and facility billing claims to ensure accuracy, compliance with coding guidelines, and regulatory requirements., • Identify potential areas of non-compliance and recommend corrective actions., • Develop and deliver educational sessions to physicians and hospital staff on medical record documentation, coding, and compliance best practices., • Serve as a resource for physicians and staff regarding coding and billing inquiries., • Stay current with changes in coding regulations, healthcare compliance, and industry best practices., • Must have: Nationally Certified Medical Coder (e.g., CPC, CCS, CCS-P)., • Three years of experience as a Medical Record Billing Compliance Auditor preferred., • Proven experience as a Medical Billing Compliance Physician Educator., • Strong understanding of professional billing, auditing, and education principles., • In-depth knowledge of medical coding guidelines (e.g., ICD-10-CM, CPT, HCPCS)., • Familiarity with state and federal healthcare regulations and compliance standards., • Excellent analytical, problem-solving, and communication skills., • Ability to work independently and collaboratively within a healthcare team., • Healthforce, Inc. offers an attractive salary and comprehensive benefits package, commensurate with experience and qualifications.Company DescriptionHealthforce, Inc., is a healthcare administrative consulting firm with a focus on revenue integrity through regulatory compliance, coding and billing guidance. Healthforce’s mission is to provide the appropriate mix of skilled business analysts, auditors and coders, equipped with affordable and flexible software for customized support, to assist client practices and facilities to reach the highest level of revenue integrity: optimal and compliantly collected revenue from accurately reported medical services that is beyond retraction by third-party payers, claim reviewers and recovery audit contractors.Healthforce, Inc., is a healthcare administrative consulting firm with a focus on revenue integrity through regulatory compliance, coding and billing guidance. Healthforce’s mission is to provide the appropriate mix of skilled business analysts, auditors and coders, equipped with affordable and flexible software for customized support, to assist client practices and facilities to reach the highest level of revenue integrity: optimal and compliantly collected revenue from accurately reported medical services that is beyond retraction by third-party payers, claim reviewers and recovery audit contractors.