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Physician Medical Coder (Primary care coding)

Boston Children's Hospital
  • Boston, MA
    3 days ago

    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

    Numbers & Facts

    LocationBoston, MA

    Skills

    • Anatomyunmatched
    • Billingunmatched
    • Billing Recordsunmatched
    • Certified Professional Coder (CPC)unmatched
    • Cisco ASA (Adaptive Security Appliance)unmatched
    • Code Reviewsunmatched
    • Communication Skillsunmatched
    • Content Management Systems (CMS)unmatched
    • Current Procedural Terminology (CPT)unmatched
    • Detail Orientedunmatched
    • Documentationunmatched
    • Healthcare Reimbursementunmatched
    • Hospitalunmatched
    • ICD-10unmatched
    • LCD (Liquid Crystal Display)unmatched
    • Medical Billingunmatched
    • Medical Codingunmatched
    • Medical Recordsunmatched
    • Medical Terminologyunmatched
    • Physiologyunmatched
    • Presentation/Verbal Skillsunmatched
    • Primary Careunmatched
    • Regulationsunmatched
    • Regulatory Complianceunmatched
    • Regulatory Requirementsunmatched
    • Reimbursementunmatched
    • Requirements Managementunmatched
    • Team Playerunmatched
    • Time Managementunmatched
    • Training Programunmatched
    • Training/Teachingunmatched
    • Writing Skillsunmatched

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