Physician Billing Auditor

Company: RWJBarnabas Health Corporate Services
Location: Oceanport
Posted on: June 19, 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, Healthcare , Oceanport, New Jersey