workday
Physician Practice Coder
Boston Medical Center
Remote, USA
Full-time
Junior · 2–5 years experience
Remote
$24.04- $33.65
Discovered 5 days ago
Role Overview
Conducts CPT and ICD-10 coding reviews by detailed examination of each line item in the physician medical record and charge session.
Performs chart audits to ensure correct coding and charge capture have been applied appropriately.
Works closely with key revenue cycle stakeholders to understand reasons for denials, root cause analysis, and feedback to providers.
Full Job Posting
JOB REQUIREMENTS
- EDUCATION:
- Associates Degree (or direct work experience equivalent to at least 2 years)
- CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
- CPC/CCS – Certified Professional Coder
- 2-5 years experience required in a multi-specialty physician coding environment to include coding, compliance, and billing processes.
- Work requires in-depth knowledge of medical terminology, ICD-10-CM and CPT-4 Work also requires basic concepts of human anatomy, physiology and pathology.
- Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
- Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
- Ability to work with accuracy and attention to detail
- Ability to solve problems appropriately using job knowledge and current policies/procedures.
- Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests.
- Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.
- Reviews and analyzes coding-related claim denials to determine the underlying cause, including incorrect CPT, ICD-10-CM, modifier, sequencing, medical necessity, documentation, or charge capture issues.
- Performs detailed review of denied claims, physician medical records, charge sessions, payer information, and applicable coding guidelines to determine whether the claim was coded and billed appropriately.
- Identifies trends and recurring denial patterns and performs root cause analysis to determine opportunities for coding, documentation, workflow, or system improvements.
- Determines appropriate coding corrections and recommends resolution of coding-related denials in accordance with CPT, ICD-10-CM, payer, Medicare, Medicaid, and other applicable guidelines.
- $24.04- $33.65
- This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.
- NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location.
- Equal Opportunity Employer/Disabled/Veterans
- According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.
KNOWLEDGE AND SKILLS:
- Work requires in-depth knowledge of medical terminology, ICD-10-CM and CPT-4 Work also requires basic concepts of human anatomy, physiology and pathology.
- Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
- Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
- Ability to work with accuracy and attention to detail
- Ability to solve problems appropriately using job knowledge and current policies/procedures.
- Ability to work cooperatively with members of the healthcare delivery team and staff, ability to handle frequent interruptions and adapt to changes in workload and work schedule and to respond quickly to urgent requests.
- Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.
- Reviews and analyzes coding-related claim denials to determine the underlying cause, including incorrect CPT, ICD-10-CM, modifier, sequencing, medical necessity, documentation, or charge capture issues.
- Performs detailed review of denied claims, physician medical records, charge sessions, payer information, and applicable coding guidelines to determine whether the claim was coded and billed appropriately.
- Identifies trends and recurring denial patterns and performs root cause analysis to determine opportunities for coding, documentation, workflow, or system improvements.
- Determines appropriate coding corrections and recommends resolution of coding-related denials in accordance with CPT, ICD-10-CM, payer, Medicare, Medicaid, and other applicable guidelines.
- Compensation Range:
- $24.04- $33.65
- This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensures as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), discretionary annual bonuses and merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family well-being.
- NOTE: This range is based on Boston-area data, and is subject to modification based on geographic location.
- Equal Opportunity Employer/Disabled/Veterans
- According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.
About Boston Medical Center
Hospitals & Health Systems8335 employeesFounded 1996
Academic medical center providing comprehensive healthcare and medical education.
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