Physician Specialty Coder- remote

Boston Children's Hospital; Westwood (MA); Remote; USD 85,000 - 110,000; Full time

Job summary

Boston Children's Hospital is seeking a Physician Specialty Coder to independently manage complex coding review, validation, and charge submission for surgical coding. You will collaborate with physicians, billing teams, and staff to resolve coding and reimbursement issues, while guiding documentation improvement and process optimization.

The role requires CPC certification, 4+ years of physician coding experience, and strong knowledge of ICD-10-CM and CPT-4.

Qualifications

• CPC certification is required and candidate has 4+ years of physician coding experience.
• Experience with ICD-10-CM and CPT-4 coding is essential.
• Strong communication and problem-solving skills are required.
• Familiarity with computerized billing systems and payer editing tools preferred.

Responsibilities

• Perform complex ICD-10, CPT, and ASA coding review and validation for assigned departments.
• Partner with physicians and clinical staff to resolve coding questions and documentation issues.
• Edit physician queries in line with policy and standards.
• Collaborate with Billing teams to ensure timely charge submission.
• Educate staff on coding accuracy, documentation requirements, and reimbursement guidelines.
• Maintain knowledge of coding regulations and reimbursement updates.
• Serve as a resource for complex billing and payment-related issues.
• Participate in quality improvement initiatives and process documentation.
• Maintain CPC certification and continuing education annually.
• Experience with Surgical coding is highly preferred.

Skills

ICD-10-CM knowledge

CPT-4 knowledge

Medical terminology

Anatomy & physiology

Payer regulations knowledge

Excellent communication

Problem-solving

Excel skills

Education

High School diploma or GED

Associate's degree preferred

Certified Professional Coder (CPC) certification

Tools

Computerized billing systems

Payer editing tools

Advanced Excel

Job description

Position Summary

The Physician Specialty Coder works independently to manage complex coding review, validation, and charge submission processes for assigned specialty departments. Specifically Surgical Coding. This role ensures accurate and compliant ICD-10, CPT, and/or ASA coding while partnering closely with physicians, billing teams, and operational staff to resolve coding and reimbursement issues. The position also serves as a resource for coding guidance, documentation improvement, and workflow optimization to support timely and accurate reimbursement.

Key Responsibilities

• Perform complex ICD-10, CPT, and/or ASA coding review and validation for assigned specialty departments.
• Partner with physicians and clinical staff to resolve coding questions and documentation issues.
• Review and edit physician queries in compliance with hospital policies and coding standards.
• Collaborate with Billing teams to ensure timely and accurate charge submission and workflow completion.
• Provide education and training to staff on coding accuracy, documentation requirements, and reimbursement guidelines.
• Maintain current knowledge of coding regulations, compliance standards, and reimbursement updates.
• Serve as a resource for complex billing, coding, and payment-related issues.
• Participate in quality improvement initiatives, operational projects, and process documentation efforts.
• Maintain CPC certification and continuing education requirements annually.
• Experience with Surgical coding highly preferred

Minimum Qualifications

Education:

• High School diploma or GED required.
• Associate's degree preferred.
• Certified Professional Coder (CPC) certification required.

Experience:

• Minimum of 4 years of physician coding experience required.
• At least 2 years of specialty or multi-specialty coding experience required.
• Strong knowledge of ICD-10-CM, CPT-4, medical terminology, anatomy, physiology, and payer regulations.
• Experience working with computerized billing systems and payer editing tools preferred.
• Advanced Excel and computer skills preferred.
• Excellent communication, organizational, and problem-solving skills required.

Schedule:

• Full-time
• remote

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, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

Benefits

• 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