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Coder, Physician Specialty (Critical Care) Job in Boston, Massachusetts

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Job Title: Coder, Physician Specialty (Critical Care)

Employer:Boston Children's Hospital
Specialties:Physician coding, Coding Validation, critical care
Required Certifications:CPC
Required Experience:1 to 2 years
Preferred Experience:3 to 4 years
Location: Boston 02215, MA, US
Date Posted:1/5/2021
At Boston Children’s Hospital, success is measured in patients treated, parents comforted and teams taught. It’s in discoveries made, processes perfected, and technology advanced. In major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As a teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Critical Care team and discover how your talents can change lives. Yours included.

The Physician Specialty Coder will be responsible for:
  • Performing complex ICD-10 and CPT review and validation or ASA coding for Critical Care Medicine.
  • Establishing and maintaining working relationships with Physicians in order to resolve specific case issues, as well as general questions and or principles.
  • Submitting bills for all patients within 48 hours of date of service.
  • Participating in coding and reimbursement training programs. Providing instruction and education to staff on accurate charge entry and medical record documentation.
  • Collaborating with our internal Compliance Department to resolve coding issues according to national standards through analysis of medical record documentation and use of standard coding rules.
  • Developing and maintaining professional skills and up to date knowledge of regulatory and compliance issues related to coding, documentation and billing. Maintaining credentials and certifications for CPC on an annual basis.
  • Performing other tasks and projects, as requested, including procedural documentation, participation in quality and operational improvement processes.

To qualify, you must have:
  • A high school diploma or equivalent required; Associate’s Degree preferred.
  • Certified Professional Coder (CPC) certification required. Pediatric experience preferred.
  • A minimum of 2 years of related experience in Physician coding with specific experience in Coding Validation and/or compliance review in a specialty or multi-specialty setting.
  • Knowledge of medical terminology, anatomy and physiology, pathophysiology, ICD-9/10-CM and CPT-4 or ASA classification systems, and regulatory agency requirements related to surgical specialties.
  • Advanced knowledge of CCI, LCD and CMS PRVU, payer editing systems such as Mckesson required. Preference for knowledge related to system integration.
  • Computer literacy and healthcare statistics computation required.
  • Excellent written and verbal communication skills in order to effectively deal with conflicting views and issues and mediate fair solutions.
  • The ability to work with diverse internal and external constituencies.
  • The ability to take responsibility and perform required tasks independently, as well as in a team environment.

Please note: During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organizational needs.

Boston Children’s Hospital offers competitive compensation and unmatched benefits, including a flexible schedule, affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement and discounted rates on T-passes (50% off). Discover your best.

Boston Children’s Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.


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