Physician Billing Auditor
Company: RWJBarnabas Health Corporate Services
Location: Oceanport
Posted on: June 19, 2022
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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
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