Rutgers, The State University of New Jersey, is seeking a Coding and Billing Auditor for University Ethics & Compliance. The Coding and Billing Auditor conducts audits and monitors physician and allied healthcare professionals billing and coding practices.
Among the key duties of this position are the following:
Responsible for conducting audits of the medical documentation supporting claims billed to third parties, and governmental payors such as Medicare and Medicaid. These audits determine whether services provided to patients and billed to payers, are consistent with medical record documentation and in accordance with appropriate Federal, state and third party billing regulations and/or standards.
Conducts coding and billing analyses related to internal investigations and interacts with the Office of General Counsel, Office of Labor Relations, Office of Academic Labor Relations and Office of Employment Equity, in order to assist investigators in conducting independent and impartial investigations of aligned and non-aligned employees.
At the direction of the Lead Coding and Billing Auditor communicates those findings to the affected healthcare professional, the department Chairperson, the Medical Staff and other appropriate personnel and provides education on issues identified.
Minimum Education and Experience:
Bachelor's Degree in a related field; or an equivalent combination of education and/or experience.
A minimum of two (2) years of related coding/billing experience.
Valid driver's license
Required Knowledge, Skills, and Abilities:
Physician and NPP Coding certifications (CPC and/or CCS-P)
In depth knowledge of third party payer reimbursement, coding and documentation requirements
Knowledge of State and Federal payers such as Medicare and Medicaid regulations
Experience in CPT-4, CDT and ICD-10 coding
Knowledge of physician billing
Experience in Microsoft Office (Word, Excel, PowerPoint and Access) software package is required.
The ability to navigate and research on the Internet
Ability to create and maintain complex work plans with strong attention to detail
Maintains confidentiality of sensitive information including, but not limited to, protected health information (PHI)
Must be able to perform each essential duty satisfactorily
The requirements listed must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability
Experience in Evaluation and Management coding
Experience working in a teaching/academic or medical environment
Physical Demands and Work Environment:
Standing, sitting, walking, talking and hearing.
Must be able to lift or exert force up to ten (10) pounds.
Must be able to travel to various campuses.
Clean Driving Record
Posting Number: 20ST0427
Location: Downtown New Brunswick
Internal Number: 111351
About Rutgers University
Rutgers, The State University of New Jersey, is a leading national public research university and the state's preeminent, comprehensive public institution of higher education. Rutgers is dedicated to teaching that meets the highest standards of excellence; to conducting research that breaks new ground; and to turning knowledge into solutions for local, national, and global communities. As it was at our founding in 1766, the heart of our mission is preparing students to become productive members of society and good citizens of the world. Rutgers teaches across the full educational spectrum: preschool to precollege; undergraduate to graduate and postdoctoral; and continuing education for professional and personal advancement. Rutgers is New Jersey's land-grant institution and one of the nation's foremost research universities, and as such, we educate, make discoveries, serve as an engine of economic growth, and generate ideas for improving people's lives.