Primary Care Medical Coder (CPC) – ICD-10/CPT Expert

Boston Children’s Hospital; Westwood (MA); Hybrid; USD 65,000 - 90,000; Full time

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, 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.

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.

Skills

Communication

Attention to detail

Teamwork

Independent work

Education

High School Diploma or GED

Associate’s Degree preferred

Tools

Computerized billing systems

Job description

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.