Physician Billing Auditor

Company: RWJBarnabas Health Corporate Services
Location: Oceanport
Posted on: August 4, 2022

Job Description:

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.Job Requirements:
  • 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.Other Duties: 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.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

Keywords: RWJBarnabas Health Corporate Services, Brick , Physician Billing Auditor, Accounting, Auditing , Oceanport, New Jersey