Medical Physician Coder

Boston Children’s Hospital; Westwood (MA); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Competitive compensation

Flexible schedules

Health insurance

Vision and dental insurance

Child care subsidies

Student loan subsidies

Generous time off

403(b) plan

Pension

License reimbursement

Cell phone discounts

T-pass discounts

Job summary

Boston Children’s Hospital is seeking a Physician Medical Coder to perform coding validation and review of charges across departments, ensuring timely and compliant submission of charges.

The role requires CPC certification, two years physician coding experience, and a strong knowledge of ICD-10-CM and CPT-4/ASA. You will collaborate with physicians, provide education, and stay current on billing guidelines and payer rules.

Qualifications

• CPC certification required.
• Two years physician medical coding experience.
• Strong knowledge of ICD-10-CM and CPT-4 or ASA coding systems.
• Knowledge of medical terminology, anatomy & physiology, and billing practices.
• Knowledge of computerized billing systems.
• Knowledge of CCI, LCD, CMS payer editing requirements.
• Strong written and verbal communication skills.
• Ability to work with physicians and diverse constituencies.
• Ability to work independently and as part of a team.

Responsibilities

• Performs complex ICD-10 and CPT-ASA coding review and validation for assigned medical departments.
• Reviews and validates physician charges for accurate billing.
• Establishes relationships with physicians to resolve coding questions.
• Participates in coding and reimbursement training and educates staff on charge entry and documentation.
• Maintains current knowledge of coding, billing, and regulatory requirements.
• Stays current on coding and reimbursement trends.

Skills

ICD-10-CM knowledge

CPT-ASA coding

Physician coding

Medical terminology

Billing & reimbursement

CCI LCD CMS knowledge

Communication skills

Independent worker

Detail oriented

Education

High School Diploma or GED

Associate’s Degree preferred

Job description

At Boston Children’s Hospital, the quality of our care and our inclusive hospital working environment lies in the diversity of our people. With patients from local communities and 160 countries around the world, we’re committed to reflecting the spectrum of their cultures while opening doors of opportunity for our team. Here, different talents, pursue common goals. Voices are heard and ideas are shared. Join us and discover how your unique contribution can change lives. Yours included.

Position Summary

The 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.
• 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

Benefits

• competitive compensation
• 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
• cell phone plan discounts
• discounted rates on T-passes

Experience the benefits of passion and teamwork.