System Professional Coding Provider Review and Education Manager

• Manages staff of educators to ensure quality and accuracy of education trainings and provides or initiates appropriate additional education as needed. Tracks staff productivity and ensures equitable distribution of work effort.
• Prepares materials and conducts employed provider coding documentation and billing education as needed and determined by the RWJBH Medical Group Coding Steering Committee and Coding Management, in accordance with new provider onboarding (pre- and post-acquisition), and as requested by Compliance and/or Management. Topics may also be determined following medical record review results.
• Utilizes appropriate federal, state and/or coding guidelines to format educational materials. Includes redacted medical record example(s) to illustrate compliant and/or non-compliant documentation.
• Responsible for creating and delivering annual and/or quarterly CPT, HCPCS and ICD-10 updates to providers, including specialty-specific updates as warranted or requested.
• Responsible for creating and maintaining education schedules in collaboration with physician leads.
• Ensures accuracy and integrity of ICD-10-CM and CPT procedure coding for professional fee accounts for the purpose of maintaining compliance with Federal and State Coding Regulations.
• Keeps current with relevant coding guidelines and Federal and State regulations, including but not limited to Evaluation and Management coding guidelines, Split / Shared services, Incident-to requirements, Teaching Physician Rules, and Telehealth rules and regulations, preparing the associated updated presentations. Delivers said education in person or remotely to RWHBH Provider staff as directed by management
• Maintains a shared organizational repository with appropriate guidelines and regulations regarding physician medical record documentation practices, including but not limited to the above topics.
• Delivers education and training delivery either remote or in person, as determined by management and deemed appropriate to the individual situation.
• Maintains attendance records in a singular database (e.g., Excel)
• Works collaboratively with Physician Billing Reviewers to present coding education to providers, along with appropriate coding references, and other materials associated with the findings of completed reviews of employed providers.
• Prepares and maintains detailed reports of educational activities.
• Maintains and staff internal “Coding Hotline” with knowledgeable staff.
• Effectively communicates coding recommendations and reasoning to medical staff members and others.
• Corresponds with the AMA and other relevant organizations as necessary
• Has effective collaborations with clinicians, health care providers, Revenue Cycle and Coding leadership.
• Supervises and supports Provider Education and Coding Staff.
• Performs other duties as assigned.

• CPC, COC, or CPC-I (aka AAPC approved instructor) required, with at least 8-10 years of combined coding, teaching and auditing experience.
• CPC-I and CPMA, in addition, are strongly preferred.
• Associate’s Degree or equivalent experience required.
• Minimum three to five years of experience in a managerial position.
• Must have advanced coding education and training with strong foundation in E/M coding.
• Prior experience in teaching and auditing E/M coding for physicians is required.
• Supervisory experience in a healthcare or coding environment strongly preferred.
• Must have extensive knowledge of CPT, HCPCS, and ICD-10-CM Official Coding Guidelines, with a comprehensive understanding of diagnosis and procedure coding systems
• Must have in-depth knowledge of coding processes, workflow management, and electronic health record (EHR) systems
• Must be proactive and work independently to prioritize multiple tasks and changes in work assignment to meet established deadlines.
• Must be able to work in a fast-paced healthcare environment, work well under pressure and have the ability to adapt to a constantly changing environment.
• Must possess organizational and planning skills, excellent verbal and written communication skills, and excellent interpersonal relationship skills.
• Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word) and coding software platforms (e.g., 3M, EncoderPro, Epic) preferred.
• Must maintain active certification(s) and participate in continuing education as required by credentialing bodies.
• 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