Professional Service Coder, Cardiovascular Surgery

Children's Hospital Boston Boston , MA 02298

Posted 3 weeks ago

Job Posting Description

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 through major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As the teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Cardiovascular Surgery and discover how your talents can change lives. Yours included.

This Professional Service Coder, Cardiovascular Surgery will be responsible for:

  • Reconciling all surgical cardiovascular encounters/events to the surgical schedule; verifying that all procedures are accounted for, documented and finalized.

  • Ensuring that accurate and optimal coding of all records are done utilizing current ICD-coding systems and Current Procedural Terminology (CPT-4) books for optimal reimbursement for services provided.

  • Verifying all NCCI edits have been reviewed. Upon reviewing each surgical encounter, assigning Fyler and STS classification codes within the cardiovascular applications.

  • Providing prior authorization and prospective code assignments of CV Surgical cases and documents hierarchical coding of comorbidities.

  • Leading the appeal processes with payers; assisting in preparing payer medical review request letters, and providing compliance assistance for payer requests.

  • Coding and abstracting surgical encounters

  • When preparing coding for billing for the department, all areas of service including off site locations, in and out patient areas. Codes (CPT-4, HCPCS Modifiers and ICD-coding systems) may include: operative procedures, office/minor procedures, and diagnostic procedures.

  • Collecting risk mortality information and maintaining the STS database.

  • Risk mortality fields include: age, weight, prior operations, non-cardiac congenital abnormalities, chromosomal abnormality, prematurity, other pre-operative factors and post-operative factors.

  • Chart reviewing and contacting family while in-house for any missing demographic and pre-operative data, including ante-natal and birth information.

  • Participating in Saturday CV Surgery M&M conference.

  • Reporting to the team new findings/changes post conference that need to documentation improvement and review of billing prior to release of billable professional claims or claims corrections.

To qualify, you must have:

  • The level of knowledge typically acquired through completion of two (2) years of occupationally-specific education or an Associate's degree in Medical Records or a closely related field plus five (5) years surgical coding experience including a minimum of two (2) years of cardiovascular coding experience.

  • Experience in a pediatric cardiovascular surgical setting is highly desirable.

  • The knowledge of anatomy and physiology sufficient to prepare for ICD-10 coding.

  • Communication skills in order to effectively deal with conflicting views or issues and mediate fair solutions and well developed writing skills.

  • Proficiency in computer and data entry and retrieval skills is required.

  • The analytical skills to gather and interpret data that require the use of basic scientific, mathematical, or technical principles.

Boston Children's Hospital offers competitive compensation and unmatched benefits, including an 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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Professional Service Coder, Cardiovascular Surgery

Children's Hospital Boston