Coder, Physician Medical

Boston Children's Hospital; Westwood (MA); Hybrid; USD 39,000 - 58,000; Full time

Benefits offered by this job

Flexible schedules

Health insurance

Vision insurance

Dental insurance

Tuition reimbursement

License/certification reimbursement

Pension / 403(b)

Job summary

Boston Children's Hospital is seeking a Primary Care Physician Medical Coder to perform coding validation and review of charges for assigned departments. The role ensures accurate, timely, and compliant submission of charges and requires CPC certification and two years of physician coding experience.

The position is full-time with a hybrid schedule and collaborative work with physicians. Responsibilities include reviewing ICD-10 and CPT/ASA codes, educating staff on documentation and charge

Qualifications

• CPC certification is required.
• Two years of physician medical coding experience.
• 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 independently and as part of a team.
• Attention to detail and accuracy.

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 questions.
• Participates in coding and reimbursement training programs and provides education to staff on documentation and charge entry.
• Initiates, reviews, and edits physician queries per hospital policy.
• 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 and reviews current coding literature.
• Maintains required CPC credentials and certification.

Skills

Communication skills

Attention to detail

Teamwork

Education

CPC certification

High School Diploma or GED

Associate's Degree preferred

Tools

Computerized billing systems

Job description

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

Pay & Benefits

The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting.

Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, employee discounts and discounted commuter benefits at certain locations. Experience the benefits of passion and teamwork.