Physician Coding Manager- remote

Boston Children’s Hospital; Westwood, Northern (MA, KY); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Remote schedule

Job summary

Boston Children’s Hospital seeks a coding Supervisor/Manager to lead Physician Organization Shared Services’ professional coding operations. The role requires hands-on leadership, CPC certification, and a strong surgical coding background.

You will mentor staff, manage denials, and collaborate with physicians and billing leadership to improve accuracy and reimbursement. The ideal candidate has about 5 years of coding leadership experience, strong Epic proficiency, and experience with denial

Qualifications

• Must have CPC certification (CCS-P or CPC-A not accepted).
• 3+ years coding experience in DRG validation/compliance review within a multi-specialty setting.

Responsibilities

• Manage coding operations, workflows, and staff assignments for accurate charges and reports.
• Lead and supervise coding staff, including onboarding, performance reviews, and trainings.
• Ensure compliance with ICD-10-CM, CPT, and HCPCS guidelines.

Skills

CPC certification

Leadership

Epic

Denial management

Physician/professional coding

Team supervision

Communication

Problem solving

Education

Associate's Degree in Medical Records

Tools

Epic

Billing systems

Job description

Position Summary

Manages and supports specialty and medical coding for Physician Organization Shared Services’ professional billing and collection functions. This is a hands‑on coding leadership role overseeing daily coding operations, supervising and supporting coding staff, ensuring accuracy and compliance, and partnering with physicians and billing leadership to improve coding and reimbursement. The ideal candidate must have a CPC certification (CPC-A candidates will not be considered) and a strong surgical physician/professional coding background. Hospital/facility coding alone does not meet the requirement. Previous coding management or supervisory experience is required, with approximately 5 years preferred, along with strong Epic and coding system edit experience. A key focus will be denial management, including identifying root causes, resolving coding and billing issues, and implementing process improvements to reduce recurring denials. The Supervisor/Manager will also provide hands‑on coaching, training, and guidance to the coding team while collaborating with physicians and leadership to improve billing accuracy.

Key Responsibilities

• Manage coding operations, work assignments, and workflows to ensure accurate and timely processing of charges, appeals, and reports.
• Lead and supervise assigned coding staff, including hiring, onboarding, training, performance management, and annual reviews.
• Ensure coding accuracy and compliance with ICD-10-CM, CPT, and HCPCS guidelines.
• Resolve missing or incomplete coding information, coding queries, and issues escalated by coding staff.
• Review coding and billing reports to identify performance issues, errors, and opportunities for improvement.
• Analyze billing system issues and work with leadership and vendors to resolve problems and maintain data integrity.
• Develop and implement coding policies, procedures, training, and workflow improvements.
• Monitor changes in coding, billing, and payer requirements and update processes accordingly.
• Support EPIC coding training and help ensure consistency and compliance across coding practices.
• Partner with physician leadership, department administrators, pricing/contracting, quality teams, and billing leadership on coding and billing initiatives.
• Review audit and chart-review findings and make recommendations to improve coding accuracy and reimbursement.
• Serve as a coding expert and resource for the Billing Management Team and physician organization.

Minimum Qualifications

• Certified Professional Coder (CPC) OR Certified Coding Specialist – Physician-Based (CCS-P) certification required.
• Strong knowledge of physician/professional coding and billing.
• Knowledge of ICD-10-CM, CPT-4, and HCPCS coding systems.
• Knowledge of medical terminology, anatomy and physiology, pathophysiology, and healthcare regulatory requirements.
• Advanced knowledge of CCI, LCD, and CMS RVU/PRVU.
• Strong analytical and problem-solving skills.
• Ability to manage and lead employees effectively.
• Strong communication, negotiation, and conflict-resolution skills.
• Ability to work effectively with diverse internal and external teams.
• Computer literacy and experience with computerized billing systems required.

Education

Associate's Degree required

Area of Study: Medical Records

Experience

3 years of coding experience in DRG Validation and/or compliance review within a multi-specialty setting.

Schedule: remote