Professional Coding Provider Educator and Reviewer

• Prepares materials and conducts provider education on coding, documentation, and billing, as directed by management, including requests from the RWJBH Medical Group Coding Steering Committee, Coding Management, Corporate Compliance, and physician leadership.
• Creates and delivers education to support new provider onboarding, as directed.
• Develops and presents education based on findings from medical record reviews.
• Performs coding and documentation audits to assess compliance and accuracy of CPT, ICD-10-CM, HCPCS codes, modifiers, and units; provides detailed written and verbal feedback.
• Utilizes applicable federal, state, and coding guidelines to develop educational content.
• Incorporates redacted medical record examples to illustrate compliant and non-compliant documentation, clearly aligning with current guidelines and including reference citations.
• Creates and delivers annual and/or quarterly CPT, HCPCS, and ICD-10 updates, including specialty-specific content as warranted or requested.
• Collaborates with providers and affiliate staff to promote accurate and compliant coding and billing practices.
• Works closely with other Professional Coding Educators, Auditors, and coding staff to present education supported by coding references and audit findings.
• Prepares detailed reports of educational activities and attendance and submits them to management at regular intervals.
• Communicates coding recommendations and rationale effectively to staff and leadership.
• Maintains current knowledge of CPT, ICD-10, HCPCS, and applicable federal, state, and payer regulations.
• Demonstrates strong working knowledge of Evaluation and Management (E/M) guidelines, Split/Shared services, Teaching Physician rules, Incident-to requirements, and Telehealth regulations; develops related educational materials as directed.
• Responds to coding inquiries from providers and staff via the Coding Support inbox and management requests; supports responses with references and logs inquiries to identify trends.
• Provides one-on-one education to physicians or staff, as requested.
• Corresponds with external organizations, as needed, to clarify coding and billing guidelines.
• Ensures accuracy and integrity of ICD-10-CM and CPT coding for professional fee accounts to maintain compliance with federal and state regulations.
• Contributes to maintaining a shared organization repository of coding and documentation guidelines and regulatory references.
• Supports Coding Hotline inquiries, as directed.
• Performs other duties as assigned.

• CPC, COC, CEMC, or CPC-I (AAPC-approved instructor) required; credentials must be maintained for continued employment.
• CPC-I strongly preferred. CPMA required or willing to obtain within 6 months of onboarding.
• Minimum 3 years of professional coding experience, including E/M teaching and auditing, is required.
• Associate’s degree or equivalent experience required.
• Comprehensive understanding of E&M coding guidelines.
• Advanced knowledge of CPT, HCPCS, and ICD-10-CM Official Guidelines; foundational understanding of diagnosis and procedure coding systems.
• Ability to work independently, prioritize multiple tasks, and adapt to changing assignments and deadlines.
• Must thrive in a fast-paced healthcare environment and demonstrate flexibility under pressure.
• Excellent verbal, written, and interpersonal communication skills.
• Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word) required.
• Experience with coding software platforms (e.g., 3M, EncoderPro, Epic) preferred.
• Some travel may be required for on-site education or audits across RWJBH medical centers.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

RWJBarnabas Health