Professional Coding Provider Educator & Reviewer

RWJBarnabas Health • Oceanport, NJ

72d • $75,597 - $106,780

About The Position

The Professional Coding Provider Educator/Reviewer is responsible for preparing educational materials and delivering instruction to Medical Group physicians, APNs, and staff across all RWJBH medical centers, as directed by the System Professional Provider Education Coding Manager and Coding Leadership. Education may be provided in response to compliance reviews, physician onboarding, proactive training, or coding and regulatory updates. This role also conducts medical record coding audits to support education needs, including one-on-one instruction for physicians or staff. The candidate must demonstrate advanced knowledge of CPT, HCPCS, and ICD-10 guidelines, review annual and quarterly coding updates, and research newly implemented guidance to respond to coding inquiries accurately and in a timely manner. Education is delivered in person or remotely, and attendance records are maintained and submitted to management at regular intervals. The selected candidate for Professional Coding Educator/Reviewer must be prepared to engage in cross-functional duties aligned with organizational priorities and leadership guidance. These may include conducting and/or supporting medical record audits, researching guidelines and regulatory sources, supporting coding operations and contributing to administrative functions as needed.

Requirements

• Associate's degree or equivalent experience required.
• Minimum 3 years coding experience, including experience in teaching coding.
• CPC, COC, CEMC, or CPC-I (AAPC-approved instructor).
• CPMA required or willing to obtain within 6 months of onboarding.
• 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.

Nice To Haves

• Bachelor's Degree.
• CPC-I.
• E/M experience.
• Experience in coding software platforms (e.g., 3M, EncoderPro, Epic) is preferred.

Responsibilities

• Prepares materials and conducts provider education on coding, documentation, and billing, as directed by management.
• 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.
• 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.
• Responds to coding inquiries from providers and staff via the Coding Support inbox and management requests.
• 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.
• 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.

Benefits

• 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!

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees