Coder, Physician Medical

Boston Children’s Hospital; Westwood (MA); Hybride; USD 65 000 - 90 000; Plein temps

Résumé du poste

Boston Children’s Hospital is seeking a Primary Care Physician Medical Coder to perform coding validation and review of charges for assigned departments, ensuring timely, accurate, and compliant submission. You will assign, sequence, validate, and/or edit codes and initiate physician queries when appropriate.

The role requires CPC certification, 2 years of physician medical coding experience, and strong knowledge of ICD-10-CM and CPT-4/ASA coding systems. Hybrid schedule with business hours.

Qualifications

• Certified Professional Coder (CPC) certification required.
• Two years of physician medical coding experience required.
• Strong knowledge of ICD-10-CM and CPT-4 or ASA coding systems.
• Knowledge of medical terminology, anatomy and physiology, pathophysiology, and healthcare billing and reimbursement practices.
• Knowledge of computerized billing systems.
• Knowledge of CCI, LCD, CMS, and payer editing requirements.
• Strong written and verbal communication skills.
• Ability to work effectively with physicians and diverse internal and external constituencies.
• Ability to work independently and as part of a team.
• Strong attention to detail and accuracy.

Responsabilités

• Performs complex ICD-10 and CPT/ASA coding review and validation for assigned medical departments.
• Reviews and validates physician charges to ensure accurate and compliant billing.
• Establishes and maintains working relationships with physicians to resolve coding, documentation, and case-related questions.
• Participates in coding and reimbursement training programs and provides education to staff on accurate charge entry and medical record documentation.
• Initiates, reviews, and/or edits physician queries in accordance with hospital policies when appropriate.
• Maintains current knowledge of coding, documentation, billing, reimbursement, regulatory, and compliance requirements.
• Stays current on coding and reimbursement rules, regulations, trends, and industry developments.
• Participates in professional development activities and reviews current coding and reimbursement literature.
• Maintains required CPC credentials and certification.

Connaissances

Communication

Attention to detail

Teamwork

Independent work

Formation

High School Diploma or GED

Associate’s Degree preferred

Outils

Computerized billing systems

Description du poste

Position Summary

The Primary Care Physician Medical Coder performs coding validation and review of charges for assigned medical departments to ensure timely, accurate, and compliant submission of charges. This position assigns, sequences, validates, and/or edits codes for assigned medical departments and initiates, reviews, and/or edits physician queries when appropriate. The Coder maintains current knowledge of coding guidelines, regulatory requirements, reimbursement practices, and hospital policies to ensure accurate and compliant coding.

Key Responsibilities

• Performs complex ICD-10 and CPT/ASA coding review and validation for assigned medical departments.
• Reviews and validates physician charges to ensure accurate and compliant billing.
• Establishes and maintains working relationships with physicians to resolve coding, documentation, and case-related questions.
• Participates in coding and reimbursement training programs and provides education to staff on accurate charge entry and medical record documentation.
• Initiates, reviews, and/or edits physician queries in accordance with hospital policies when appropriate.
• Maintains current knowledge of coding, documentation, billing, reimbursement, regulatory, and compliance requirements.
• Stays current on coding and reimbursement rules, regulations, trends, and industry developments.
• Participates in professional development activities and reviews current coding and reimbursement literature.
• Maintains required CPC credentials and certification.

Minimum Qualifications

• Certified Professional Coder (CPC) certification required.
• Primary Coding experience
• Two years of physician medical coding experience required.
• Strong knowledge of ICD-10-CM and CPT-4 or ASA coding systems.
• Knowledge of medical terminology, anatomy and physiology, pathophysiology, and healthcare billing and reimbursement practices.
• Knowledge of computerized billing systems.
• Knowledge of CCI, LCD, CMS, and payer editing requirements.
• Strong written and verbal communication skills.
• Ability to work effectively with physicians and diverse internal and external constituencies.
• Ability to work independently and as part of a team.
• Strong attention to detail and accuracy.

Education: High School Diploma or GED required. Associate’s Degree preferred.

Experience: Two years of physician medical coding experience required.

Schedule: Full time- business hours: Hybrid