[Hiring] Physician Coding Manager @Boston Childrens Hospital

Role Description

Manages and supports specialty and medical coding for Physician Organization Shared Services’ professional billing and collection functions. This is a hands-on coding leadership role overseeing daily coding operations, supervising and supporting coding staff, ensuring accuracy and compliance, and partnering with physicians and billing leadership to improve coding and reimbursement.

The ideal candidate must have a CPC certification (CPC-A candidates will not be considered) and a strong surgical physician/professional coding background. Hospital/facility coding alone does not meet the requirement. Previous coding management or supervisory experience is required, with approximately 5 years preferred, along with strong Epic and coding system edit experience.

A key focus will be denial management, including:

• Identifying root causes
• Resolving coding and billing issues
• Implementing process improvements to reduce recurring denials

The Supervisor/Manager will also provide hands-on coaching, training, and guidance to the coding team while collaborating with physicians and leadership to improve billing accuracy.

Qualifications

• Certified Professional Coder (CPC) OR Certified Coding Specialist – Physician-Based (CCS-P) certification required
• Strong knowledge of physician/professional coding and billing
• Knowledge of ICD-10-CM, CPT-4, and HCPCS coding systems
• Knowledge of medical terminology, anatomy and physiology, pathophysiology, and healthcare regulatory requirements
• Advanced knowledge of CCI, LCD, and CMS RVU/PRVU
• Strong analytical and problem-solving skills
• Ability to manage and lead employees effectively
• Strong communication, negotiation, and conflict-resolution skills
• Ability to work effectively with diverse internal and external teams
• Computer literacy and experience with computerized billing systems required

Requirements

• 3 years of coding experience in DRG Validation and/or compliance review within a multi-specialty setting

Company Description