RWJBH Job - 34368251 | CareerArc
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Company: RWJBH
Location: Oceanport, NJ
Career Level: Associate
Industries: Healthcare, Pharmaceutical, Biotech


Job Summary:

The Lead Physician Billing Educator provides oversight assistance to Physician educators in terms of presentation preparedness as necessary.

Essential Functions:

    • Prepares annual education plan to follow with annual Physician Review Work Plan with equitable distribution of education between Education staff in collaboration with Lead Physician Reviewer and Manager.
    • Ensures equitable distribution of additional provider education as requested by Compliance and/or Management.
    • Prepares and conducts employed provider education presentations, in accordance with new provider on-boarding (pre and post-acquisition), and as per Compliance and/or Management requests.
    • 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 Lead Physician Billing Educator to distribute follow up review education needs. Provides audit results, coding references, and other materials associated with completed reviews of employed providers, including research, and associated research documentation.
    • May cross cover Lead Physician Reviewer as needed.
    • Distributes coding questions as received in an equitable fashion and provides a secondary review of advice. Final advice is reviewed by Manager.
    • Prepares webinars / assigns the presentation of webinar on topics to be delivered remotely on topics of interest with Management oversight.
    • Prepares detailed reports of educational activities and maintains attendance records.
    • 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.
    • 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 a Bachelor's Degree; Master's degree preferred.
  • Coding certification required (e.g. CCS, CCS-P, CPC, COC, CEMC), RHIT, RHIA, and/or RN also encouraged.
  • 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, oral, and written communication skills. Must have excellent organizational and time management skills. Must be able to work independently with minimal supervision.
  • Must be able to utilize a personal computer with Windows and Microsoft Office software, especially Word, Excel and PowerPoint. Must be able to utilize the 3M Coding and Reimbursement Software system.
  • Must be able to utilize 3 M SoftMed, Cerner, Allscripts SCM and other electronic medical records systems for remotely reviewing of medical records.

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

RWJBarnabas Health is the most comprehensive health care delivery system in New Jersey and the state s second largest private employer with more than 32,000 employees, 9,000 physicians and 1,000 residents and interns. The system includes eleven acute care hospitals, three acute care children s hospitals and a leading pediatric rehabilitation hospital (Children s Specialized Hospital).

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