Coding Auditor/Educator, Physician Billing (PB)

Overview

The Physician Billing (PB) Coding Auditor and Educator is responsible for auditing and educating healthcare providers on related applicable clinical documentation. This work supports coding and billing regulations that ensure appropriate reimbursement, public reporting, and various initiatives as directed by the Hackensack Meridian Health (HMH) Network.

Responsibilities

A day in the life of a Physician Billing (PB) Coding Auditor and Educator at Hackensack Meridian Health includes:

• Comply with established corporate and departmental policies, procedures, objectives, quality assurance methods, and safety codes. Demonstrate compliance with licensing, regulatory, and accrediting agency provisions as required.
• Perform coding quality audits of all records (outpatient, inpatient, procedures, diagnostic testing) to assure appropriateness and accurate code assignments in accordance with Center of Medicare and Medicaid (CMS) guidelines and provide ongoing feedback and analysis of the education needs for the providers and staff.
• Create spreadsheets and summaries of audit findings.
• Assist providers, practices, internal/external coding team(s), revenue cycle analysts (RCA), and Training Teams with coding inquiries.
• Clarify complex discrepancies in documentation and coding; assure accuracy and timeliness of coding assignments to expedite the billing process and facilitate data retrieval for physician access and ongoing patient care.
• Perform follow-up complex coding of medical records per internal or external audits identified as Coding discrepancies.
• Meet or exceed productivity and quality standards and established department benchmarks.
• Maintain annual mandatory education requirements specific to the position as mandated by HMH.
• Keep abreast of coding guidelines and reimbursement reporting requirements, new technology, and procedures in accordance with the CMS and Office of Inspector General (OIG) regulations.
• Bring identified concerns to the department manager and Director for resolution.
• Participate in other special projects, duties and/or projects as assigned.
• Adhere to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
• Minimum of 5 years of Physician Coding experience in a large multi-specialty group.
• Experience and thorough knowledge of ICD-10 and CPT coding.
• Knowledge of data reporting requirements and proficiency in computer skills.
• Extensive knowledge in data collection and physician coding reviews.
• Must have advanced coding education and training with a strong foundation in E/M Coding.
• Knowledge of Coding software and Google Suite: Sheets, Slides, and Docs.
• Excellent oral and written communication skills.
• Ability to work independently in a fast-paced environment.
• Ability to interact with management personnel and the provider community.

Education, Knowledge, Skills and Abilities Preferred:

• Associate's degree or higher.
• Minimum of 2 years of physician quality improvement auditing/education experience.

Licenses and Certifications Required:

• Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Specialist (CCS); or Certified Professional Coder (CPC) Certification.
• Certified Professional Medical Auditor (CPMA) at hire or must obtain within one (1) year of hire.

Licenses and Certifications Preferred:

• Certified Risk Adjustment Coder (CRAC).

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

Starting Minimum RateMinimum rate of $105,747.20 Annually Job Posting DisclosureHMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to: Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness. Experience: Years of relevant work experience. Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training. Skills: Demonstrated proficiency in relevant skills and competencies. Geographic Location: Cost of living and market rates for the specific location. Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization. Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered. Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.