Physician Specialty Coder (Shared Service Center)

To be considered a qualified candidate, you must be a seasoned and strong surgical coder with understanding of CCI edits and guidelines along with all the surgical modifiers, teaching attestations, and global periods and with experience writing appeals and NOC letters. Surgical coder candidates should have the skillset to work independently on their assigned surgical specialties. Additionally as requested to work collaboratively with team members to cross train and assist in other surgical-specialties.

The Physician Specialty Coder will be responsible for:

• Performing ICD-10 review and complex CPT Coding Validation or ASA coding for assigned surgical specialty departments.
• Establishing and maintaining working relationships with Physicians to communicate and resolve specific case issues, as well as general questions and or coding principles.
• Developing and maintaining professional skills. Participating in professional organizations and staying abreast of the latest relevant literature and resources.
• Remaining current on coding and reimbursement rules, with an up to date knowledge of regulatory and compliance issues related to coding, documentation and billing trends and developments.
• Acting as a resource for the Shared Service Center, providing assistance with complex billing/coding systems and payment issues.
• Providing instruction and education to coworkers on accurate charge entry and medical record documentation.
• Maintaining credentials and certifications for CPC on an annual basis.

To qualify, you must have:

• High School diploma or equivalent required. Associate degree preferred.
• Certified Professional Coder (CPC) certification required
• Minimum of 2 years of experience in Physician coding with specific experience in Surgical CPT Coding Validation in a specialty or multi-specialty setting. And knowledge of coding requirements for services furnished in a teaching setting.
• Knowledge of medical terminology, anatomy and physiology, pathophysiology, ICD10-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
• Computer literacy with knowledge of computerized billing system and healthcare statistics computation
• Excellent written and verbal communication skills
• Full remote position - with the exception of CA.
• Ability to work Monday - Friday, within the hours of 6:00a - 5:00p Eastern.

Boston Children's Hospital offers competitive compensation and unmatched benefits including 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.