Physician Medical Coder (Primary care coding)

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:

Schedule: Full time- business hours: Hybrid

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, employee discounts and discounted commuter benefits at certain locations. Experience the benefits of passion and teamwork.