Physician Billing Auditor, Medical Records

4 weeks ago


Oceanport NJ, United States RWJBarnabas Health Corporate Services Full time

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.
Must have advanced coding education and training with strong foundation in E/M coding.
Bachelor s degree preferred.
Prior E/M physician auditing experience preferred.
Prior supervisory experience and/or coding consultant experience preferred.
Coding certification required e,g, CCS, CCS-P, CPC, COC, CEMC; 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.
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.
with coding questions as necessary.
May be required to assist in the formation of Corrective Action Plans for the employed physicians and affiliate staff.
At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.
Medical and Prescription Drug Insurance
Dental and Vision Insurance
Retirement Plans
Short & Long Term Disability
Tuition Reimbursement
Health Care/Dependent Care Flexible Spending Accounts
Choosing RWJBarnabas Health
RWJBarnabas Health is the premier health care destination providing patient-centered,
high-quality academic medicine in a compassionate and equitable manner, while delivering
a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.
RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.



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