UMass Memorial Health

Role Description Responsible for interpreting medical record data in order to process physician and/or facility charges. Assigns appropriate ICD-CM (current edition), CPT codes and modifiers as appropriate. Coordinates and performs work of assigned Coding Specialists and monitors progress and work quality. Trains employees, provides employee performance data, and fosters process improvements. - Distributes and monitors the flow of work for coding staff. - Provides training and technical assistance to employees within the assigned work area. - Assists supervisor in ensuring that assigned employees are provided with appropriate resources, materials, and methods. - Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel. - Relays work instruction from the supervisor. - Reviews coded records for coding quality assurance. - Provides instruction and feedback to coding staff regarding proper coding assignment as necessary. - Acts as a point person/department resource for special projects/programs and responds to coding related questions and issues. - Assists in MD, Resident and Nursing documentation reviews, audits, and educational sessions as applicable. - 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. - Abstracts and enters all codes and required demographic information into the UMMHC computer system and/or onto encounter forms. - Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing. - Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines. - Participates in quality assurance and performance measurement reviews and reporting. - Communicates to supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner. - Informs management of any coding irregularities or trends contrary to policy or procedure, and communicates with clinical staff if necessary and appropriate. - Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation. Qualifications - High School education, plus medical coding certification and training in medical terminology from an accredited program. Recognized programs include: AHIMA, NHA, and AAPC. Requirements - Five years of medical abstraction and coding experience or related work experience. - 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. - The ability to lead, organize, and support the work of less senior Coding Specialists is a primary function of this position. - Requires good interpersonal and communications skills and maintains a professional manner when working with team members, management and other staff members. - Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word. - Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Benefits - This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

Role Description Collaborates closely with operational stakeholders and is responsible for the selection, development, implementation, testing, documentation, maintenance, and adoption of application software to effectively meet clinical or business information system needs. Major Responsibilities: - Project and Meeting Leadership: - Proactively identifies barriers to completing work and escalates issues with proposed solutions. - Attends all required meetings, assumes accountability for assigned follow-ups, and practices closed loop communication. - Participates as workstream lead on cross-functional projects, ensuring tasks are completed within scope and project management guidelines. - Runs optimization requests, including scheduling meetings, identifying timelines, and allocating resources. - Stakeholder Engagement: - Develops and maintains partnerships with operational staff, serving as a subject matter advisor for application-related questions. - Leads discussions with subject matter experts, caregivers, and vendors to evaluate, design, and configure application features. - Product Evaluation and Application Support: - Attends product demonstrations to assess system functionality against customer requirements and recommends appropriate software solutions. - Facilitates application upgrade processes, including recommending new functionalities to operational caregivers. - Tests new features and functionalities and develops Job Aids for customer support and training. - Issue Investigation and Troubleshooting: - Investigates application and system configuration issues to develop and implement effective system fixes. - Participates in ticket triage and analysis to determine the appropriate work stream and assist in scoping efforts. - Independently troubleshoots application components within server configurations, including system services and interface jobs, and engages other teams as necessary. - Effectively participates in critical incident response and escalates appropriately as needed. - Collaboration and Configuration: - Collaborates with subject matter experts, caregivers, and vendors to evaluate and configure application features. - Configures application features, security settings, and develops support documentation, including test scripts and workflow diagrams. - Builds relationships with third-party vendors to maintain vendor software. - Documentation and Training: - Develops support documentation for application teams, including test scripts, workflow diagrams, and knowledge base articles. - Partners with the training team to create end-user training materials. - Mentorship: - Mentors less experienced team members, providing guidance and support for their development. - Continuous Learning: - Actively learns and applies new skills to improve support for customers and coworkers. - Continuously advances knowledge of current products, including obtaining application certifications and staying updated on system configurations and emerging technology and industry trends. - Actively participates in professional development programs defined by the department. - Adaptability: - Demonstrates high adaptability to dynamic responsibilities and evolving project requirements. - Must be able to work off hours as needed and participate in an on-call rotation. Qualifications - License/Certification/Education: - High school diploma or GED. - Epic certification(s) or ability to achieve, as required by department. - Experience/Skills: - 3 years experience with enterprise platforms (EHRs/ITSM/ERPs). - Team player with strong problem solving, time management, and decision-making skills; ability to maintain a positive attitude, solution focused. - Able to act independently with minimal oversight. - Able to serve as a mentor to less experienced team members. - Able to lead meetings and effectively communicate with all users at all levels of the organization. - Preferred: - Healthcare experience. Benefits - This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

Role Description Responsible for reviewing, researching and resolving self-pay credit accounts for both hospital and physician accounts. - Works assigned workqueues within established protocols. - Reviews and researches the processing of self-pay credit balances. - Requests refunds where necessary and/or applies credit balances to existing outstanding balances. - Troubleshoots credit files going to the bank. - Performs reconciliation on accounts. - Processes patient and Central Business Office correspondence. - Documents all actions taken in the billing system. - Completes daily statistic summary reports/logs. Standard Staffing Level Responsibilities: - Complies with established departmental policies, procedures and objectives. - Attends variety of meetings, conferences, seminars as required or directed. - Demonstrates use of Quality Improvement in daily operations. - Complies with all health and safety regulations and requirements. - 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. - Maintains regular, reliable, and predictable attendance. - Performs other similar and related duties as required or directed. All responsibilities are essential job functions. Qualifications - High School diploma. Requirements - Three years of relevant work experience. - Knowledge of third party insurance and medical terminology. - Computer skills. - Ability to work independently within established functional guidelines and withstand pressure that may arise when dealing with the public, physicians/clinic and staff. Benefits - This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

Role Description Interprets a wide variety of clinical and diagnostic documentation to determine the opportunity for Hierarchical Condition Category (HCC) diagnosis selection and/or removal in accordance with official coding guidelines. Assigns appropriate ICD-CM (current edition) codes to outpatient office-based claims, tracks capture results, and reports clinical documentation patterns and trends. Supports all risk adjustment projects by complying with CMS requirements. Major Responsibilities: - Upon review of the medical record, performs analysis on documentation to determine the appropriate ICD-CM (current edition) codes as defined by official coding guidelines and other recognized reference materials. - Builds partnerships and works within coding teams and other organization departments critical to HCC coding. - Reviews coded records for coding quality assurance. - Verifies documentation is present to substantiate codes assigned. - Participates in the continuous coding audit and performance management program. - Maintains coding accuracy rate of not less than 95% for optimal reimbursement as well as department productivity standards as outlined in department policies. - Attends required training classes and coding in-services each year to stay abreast of new regulations and coding guidelines. - Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines. - Alerts management to any unusual or questionable situations, coding irregularities, or trends contrary to policies/procedures, so corrective measures may be taken. - Adheres to the coding and billing regulations established by the American Hospital Association (AHA), American Medical Association (AMA), and Centers for Medicare and Medicaid Services (CMS). - Maintains direct and ongoing communications with other coding personnel to maximize overall effectiveness and efficiency of the operation. Standard Staffing Level Responsibilities: - Complies with established departmental policies, procedures and objectives. - Attends a variety of meetings, conferences, seminars as required or directed. - Demonstrates use of Quality Improvement in daily operations. - Complies with all health and safety regulations and requirements. - 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. - Maintains regular, reliable, and predictable attendance. - Performs other similar and related duties as required or directed. Qualifications - High School diploma or equivalent. - Medical coding training and medical terminology from an accredited program. - Certification(s) as a Certified Coding Specialist (CCS), Certified Coding Specialist - Physician (CCS-P), Certified Professional Coder (CPC), or Certified Risk Adjustment Coder (CRC). Requirements - Three (3) years of HCC and/or outpatient coding experience. - Thorough knowledge of risk adjustment payment methodologies. - Thorough knowledge of ICD-CM (current edition) and CPT coding as well as CCI edits. - Thorough knowledge of third-party payer requirements as well as federal and state guidelines and regulations pertaining to coding and billing practices. - Excellent interpersonal and communications skills and demonstrates professionalism. - Excellent customer service skills with the ability to communicate efficiently. - Exceptional organizational skills with attention to detail. - Ability to work independently within established guidelines. - Ability to organize and coordinate multiple functions and tasks. - Ability to problem solve, organize and prioritize workload to meet productivity benchmarks. - Ability to withstand significant level of ongoing pressure, and ability to deal with individuals with tact, discretion and diplomacy. Benefits - This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

Role Description UMass Memorial Health and UMass Chan Medical School are seeking a psychiatrist with expertise in women's mental health and integrated care to serve as the Medical Director of MCPAP for Moms, a nationally recognized statewide program that supports perinatal care providers in addressing perinatal mental health and substance use disorders. - 0.5 FTE leadership position (remote or in-person) - Medical Director of MCPAP for Moms - Provide clinical consultation to perinatal care providers across Massachusetts - Collaborate with Perinatal Psychiatry Access Programs nationwide - Academic appointment through UMass Chan Medical School - Opportunities for teaching, research, publications, and presentations - Additional clinical opportunities available for interested candidates Qualifications - MD or DO with Board Certification/Eligibility in Psychiatry - Demonstrated expertise or strong interest in women's mental health and perinatal psychiatry - Leadership experience or leadership potential - Interest in integrated care, education, and program development - Eligibility for Massachusetts medical licensure Requirements - Hiring Range: $215,000 - $222,000 - Location: Worcester, MA - Schedule: Part-Time, Remote or in-person Benefits - Employer-funded retirement contributions of 8% of base salary with additional retirement plan options - Tuition reimbursement, student loan forgiveness support, and PSLF-eligible employment - Concierge services for relocation to include special mortgage promotions - Professional liability insurance coverage of $5 million per claim and $10 million aggregate - Organization-wide commitment to formal Clinician Wellness Program

Role Description Responsible for interpreting medical record data in order to process physician and/or facility charges. Assigns appropriate ICD-CM (current edition), CPT codes and modifiers as appropriate. Coordinates and performs work of assigned Coding Specialists and monitors progress and work quality. Trains employees, provides employee performance data, and fosters process improvements. - Distributes and monitors the flow of work for coding staff. - Provides training and technical assistance to employees within the assigned work area. - Assists supervisor in ensuring that assigned employees are provided with appropriate resources, materials, and methods. - Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel. - Relays work instruction from the supervisor. - Reviews coded records for coding quality assurance. - Provides instruction and feedback to coding staff regarding proper coding assignment as necessary. - Acts as a point person/department resource for special projects/programs and responds to coding related questions and issues. - Assists in MD, Resident and Nursing documentation reviews, audits, and educational sessions as applicable. - 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. - Abstracts and enters all codes and required demographic information into the UMMHC computer system and/or onto encounter forms. Qualifications - High School education, plus medical coding certification and training in medical terminology from an accredited program. - Recognized programs include AHIMA, NHA, and AAPC. - CPC certified and experience in IR coding. Requirements - Five years of medical abstraction and coding experience or related work experience. - 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. - The ability to lead, organize, and support the work of less senior Coding Specialists is a primary function of this position. - Requires good interpersonal and communications skills and maintains a professional manner when working with team members, management and other staff members. - Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word. Benefits - This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

Role Description 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. - 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. - 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. - Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing. - May participate in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines. - May participate in quality assurance and performance measurement reviews and reporting. - Informs supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner. - Alerts management to any coding irregularities or trends contrary to policy/procedure so that corrective measures can be taken. - Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation. - Completes patient’s abstracts mandated by Federal and State regulatory agencies, Physician Peer Review, and hospital planning for optimal facility utilization (i.e. Determination of Need, Quality Assurance, research studies and Utilization Review Program). Qualifications - High School education, plus medical coding certification. - Training in medical terminology from an accredited program (Preferred). Recognized programs include: AHIMA, NHA, and AAPC. - Three years of medical abstraction and coding experience or related work experience (Required). - 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 (Required). - Intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word (Required). - Good interpersonal and communications skills and demonstrates professionalism when working with team members, management and other staff members (Required). Requirements - Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Benefits - This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.

Role Description Under the general supervision of the Bridge Clinic Medical Director physician, the APP is responsible for providing telehealth primary care medical services to ensure that the patient has access to interim care while awaiting their new patient appointment with a new UMass Primary Care Physician. These services include: - Obtaining complete medical history and performing limited virtual physical examination - Ordering and interpreting laboratory tests and imaging studies - Closing care gaps - Formulating a diagnosis and treatment plan - Prescribing and/or dispensing medication - Providing specialty referrals when appropriate - Counseling patients and families This is a remote position with flexible scheduling. Part-time opportunity available. Major Responsibilities - Performs and documents a complete history and physical examination, including review of the available medical record, to formulate diagnoses and treatment plan. - Orders and reviews appropriate laboratory tests and imaging studies. - Requests consultations and communications with consultants. - Prescribes oral or parenteral medication to outpatients in accordance with state law, UMMHC policy, and as provided in the Delineation of Privileges and Guidelines for Prescribing. - Orders consultations for subspecialty care and allied health services, including speech, respiratory, and physical therapy. - Provides counseling and teaching, related to the management and prevention of disease, for patients and family members. - Actively maintains all required credentials, including state licensure, state-controlled substance registration, federal DEA registration, NCCPA certification, BLS and ACLS certification. - Serves as a resource for the teaching, training and orientation of students and colleagues. - Participates in clinical research, and contributes to clinical conferences, rounds, and quality-control meetings. - Promptly completes all outstanding medical records as required by the needs of each clinical service. - Evaluates patient primary care clinic and when appropriate in person in outpatient clinic, accurately documenting each encounter. - Demonstrates a commitment to ongoing quality improvement; complies with institutional and departmental policies and procedures; complies with health and safety regulations. - Performs other similar and related duties as required and directed. Qualifications - A Masters degree from an accredited Nurse Practitioner program - Eligible or current Massachusetts license, with national certification (ANCC, AANP, NCCPA, as applicable) - Massachusetts Controlled Substances Registration and federal DEA Controlled Substance Registration are required. - Experience in Primary Care, ideally experience managing your own patient panel - Experience with virtual care - EPIC – medical record use as well as virtual care platform Benefits - Comprehensive medical, dental and vision coverage - Generous paid time off with 11 paid holidays - Practice/CME allowance - Paid family and medical leave; short-term and long-term disability programs - Tuition reimbursement, student loan forgiveness support, and PSLF‑eligible employment - Concierge services for relocation - Organization-wide commitment to formal Clinician Wellness Program

Role Description Collaborates closely with operational stakeholders and is responsible for the selection, development, implementation, testing, documentation, maintenance, and adoption of application software to effectively meet clinical or business information system needs. Major Responsibilities: - Project and Meeting Leadership: - Proactively identifies barriers to completing work and escalates issues with proposed solutions. - Attends all required meetings, assumes accountability for assigned follow-ups, and practices closed loop communication. - Participates as workstream lead on cross-functional projects, ensuring tasks are completed within scope and project management guidelines. - Runs optimization requests, including scheduling meetings, identifying timelines, and allocating resources. - Stakeholder Engagement: - Develops and maintains partnerships with operational staff, serving as a subject matter advisor for application-related questions. - Leads discussions with subject matter experts, caregivers, and vendors to evaluate, design, and configure application features. - Product Evaluation and Application Support: - Attends product demonstrations to assess system functionality against customer requirements and recommends appropriate software solutions. - Facilitates application upgrade processes, including recommending new functionalities to operational caregivers. - Tests new features and functionalities and develops Job Aids for customer support and training. - Issue Investigation and Troubleshooting: - Investigates application and system configuration issues to develop and implement effective system fixes. - Participates in ticket triage and analysis to determine the appropriate work stream and assist in scoping efforts. - Independently troubleshoots application components within server configurations, including system services and interface jobs, and engages other teams as necessary. - Effectively participates in critical incident response and escalates appropriately as needed. - Collaboration and Configuration: - Collaborates with subject matter experts, caregivers, and vendors to evaluate and configure application features. - Configures application features, security settings, and develops support documentation, including test scripts and workflow diagrams. - Builds relationships with third-party vendors to maintain vendor software. - Documentation and Training: - Develops support documentation for application teams, including test scripts, workflow diagrams, and knowledge base articles. - Partners with the training team to create end-user training materials. - Mentorship: - Mentors less experienced team members, providing guidance and support for their development. - Continuous Learning: - Actively learns and applies new skills to improve support for customers and coworkers. - Continuously advances knowledge of current products, including obtaining application certifications and staying updated on system configurations and emerging technology and industry trends. - Actively participates in professional development programs defined by department. - Adaptability: - Demonstrates high adaptability to dynamic responsibilities and evolving project requirements. - Must be able to work off hours as needed and participate in an on-call rotation. Qualifications - License/Certification/Education: - Bachelor's degree in Computer Science or related field, or equivalent work experience. - Epic certification(s) or ability to achieve, as required by department. - Experience/Skills: - 3 years experience with enterprise platforms (EHRs/ITSM/ERPs). - Team player with strong problem solving, time management, and decision-making skills; ability to maintain a positive attitude, solution-focused. - Able to act independently with minimal oversight. - Able to serve as a mentor to less experienced team members. - Able to lead meetings and effectively communicate with all users at all levels of the organization. - Preferred: - Healthcare experience. Requirements - Unless certification, licensure, or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. - Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. Physical Demands and Environmental Conditions - Work is considered sedentary. - Position requires work indoors in a normal office environment.

Role Description Collaborates closely with operational stakeholders and is responsible for the selection, development, implementation, testing, documentation, maintenance, and adoption of application software to effectively meet clinical or business information system needs. Major Responsibilities: - Project and Meeting Leadership: - Proactively identifies barriers to completing work and escalates issues with proposed solutions. - Attends all required meetings, assumes accountability for assigned follow-ups and practices closed loop communication. - Participates as workstream lead on cross-functional projects, ensuring tasks are completed within scope and project management guidelines. - Runs optimization requests, including scheduling meetings, identifying timelines, and allocating resources. - Stakeholder Engagement: - Develops and maintains partnerships with operational staff, serving as a subject matter advisor for application-related questions. - Leads discussions with subject matter experts, caregivers, and vendors to evaluate, design and configure application features. - Product Evaluation and Application Support: - Attends product demonstrations to assess system functionality against customer requirements and recommends appropriate software solutions. - Facilitates application upgrade processes, including recommending new functionalities to operational caregivers. - Tests new features and functionalities and develops Job Aids for customer support and training. - Issue Investigation and Troubleshooting: - Investigates application and system configuration issues to develop and implement effective system fixes. - Participates in ticket triage and analysis to determine the appropriate work stream and assist in scoping efforts. - Independently troubleshoots application components within server configurations, including system services and interface jobs, and engages other teams as necessary. - Effectively participates in critical incident response and escalates appropriately as needed. - Collaboration and Configuration: - Collaborates with subject matter experts, caregivers, and vendors to evaluate and configure application features. - Configures application features, security settings, and develops support documentation, including test scripts and workflow diagrams. - Builds relationships with third-party vendors to maintain vendor software. - Documentation and Training: - Develops support documentation for application teams, including test scripts, workflow diagrams, and knowledge base articles. - Partners with the training team to create end-user training materials. - Mentorship: - Mentors less experienced team members, providing guidance and support for their development. - Continuous Learning: - Actively learns and applies new skills to improve support for customers and coworkers. - Continuously advances knowledge of current products, including obtaining application certifications and staying updated on system configurations and emerging technology and industry trends. - Actively participates in professional development programs defined by department. - Adaptability: - Demonstrates high adaptability to dynamic responsibilities and evolving project requirements. - Must be able to work off hours as needed and participate in an on-call rotation. Qualifications - License/Certification/Education: - Bachelor's degree in Computer Science or related field, or equivalent work experience. - Epic certification(s) or ability to achieve, as required by department. - Experience/Skills: - 3 years experience with enterprise platforms (EHRs/ITSM/ERPs). - Team player with strong problem solving, time management and decision-making skills, ability to maintain a positive attitude, solution focused. - Able to act independently with minimal oversight. - Able to serve as a mentor to less experienced team members. - Able to lead meetings and effectively communicate with all users at all levels of the organization. Benefits - This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process.