Physician Billing Auditor - Medical Records (FT) - Hybrid Req #:
Professional / Management Status:
RWJBarnabas Health Corporate Services Department:
Medical Records Location:
System Business Office, 2 Crescent Place, Oceanport, NJ 07757 Job Summary:
The Physician Billing Auditor prepares and conducts employed provider billing audits according to the current year Work Plan, in accordance with new provider on-boarding (pre- and post-acquisition), and as per Compliance and/or Management requests.Essential Functions:
- Reviews ICD-10-CM coding performed by employed providers and/or affiliate staff for accuracy and completeness.
- Reviews HCPCS/CPT coding performed by employed providers and/or affiliate staff for accuracy and completeness.
- Reviews Evaluation and Management (E/M) coding performed by employed providers and/or affiliate staff for accuracy and completeness.
- Works collaboratively with providers and affiliate staff to promote and ensure correct and compliant coding and billing practices.
- Works collaboratively with Physician Billing Educators providing audit results, coding references, and other materials associated with completed reviews of employed providers, including research, and associated research documentation.
- Prepares detailed reports of review activities.
- Maintains proper computer and written records of all review activity.
- Effectively communicates coding recommendations and reasoning to medical staff members and others.
- Performs regulatory coding research for Compliance Department and/or employed providers and affiliate staff.
- Performs physician RAC coding reviews and prepares appeals when warranted.
- Assists internal and external Compliance counsel in external agency investigations as required.
- Corresponds with AMA, etc. with coding questions as necessary.
- May be required to assist in the formation of Corrective Action Plans for the employed physicians and affiliate staff.
- Must have a minimum of an Associate s Degree; Bachelor s degree preferred.
- Must have advanced coding education and training with strong foundation in E/M coding.
- Prior E/M physician auditing experience preferred.
- Prior supervisory experience and/or coding consultant experience preferred.
- Must have excellent interpersonal skills.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.Additional Information:
We offer a great work environment, competitive rates and excellent benefits, including:
- Medical/Dental/Vision plans
- 401 (k)
- Vacation/Personal/Holiday/Sick Time Off
- Short & Long Term Disability
- Basic Life & Accidental Death Insurance
- Tuition Reimbursement
- Health Care/Dependent Care Flexible Spending Accounts
RWJBarnabas Health is an Equal Opportunity Employer
How do you build a healthier New Jersey? Every day at RWJBarnabas Health, extraordinary people like you come together to shape the answer. In our newly-integrated network of busy urban medical centers, acclaimed teaching and research facilities, and state-of-the-art community hospitals, we’re delivering world-class care to more than 5 million people across the Garden State — and redefining the career expectations of every member of our team.
We’re proud to be one of New Jersey’s premier employers, with a strong financial foundation and an outstanding national reputation for excellence in health care. At the same time, we feel like an extended family: A dynamic collection of diverse and passionate individuals with unique skills, deep roots in the communities we serve, and a shared belief that we’re better together.
We know that the best way to serve our state is to build the strongest team in the country. We’re doing that by creating a compelling matrix organization that offers the unrivaled flexibility to explore opportunities across the entirety of our network — so you can make the choices that will position you to grow and thrive for years to come.
How do you build a better future? By focusing on quality of life. Great relationships. Community focus. And tremendous opportunities for lifelong learning and professional growth. Take a closer look at RWJ Barnabas Health, and you’ll s
- Corrective And Preventive Action (Capa)
- Icd 10 Medical Classification
- Interpersonal Skills