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Certified Professional Coder

Integrated Resources, Inc

Hopewell, NJ

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JOB DETAILS
JOB TYPE
Contractor
SKILLS
Acute Care, Analysis Skills, Auditing, Billing, Billing Records, Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Clinical Data, Corporate Policies, Credit Analysis, Data Processing, Diagnosis-Related Group (DRG), Documentation, Health Information Management, Healthcare, High School Diploma, ICD-10, Medical Billing, Medical Coding, Medical Records, People Management, Process Improvement, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Registered Nurse (RN), Regulations, Regulatory Compliance, Staff Training, Statistics, Trend Analysis, Utilization Management, Validation Testing
LOCATION
Hopewell, NJ
POSTED
1 day ago
Job Summary: This position is responsible for leading audits of hospital billing and coding practices, including desk audits, bill verification, DRG validation/utilization review audits, and credit balance reviews. The role also supports audit protocol development, trend analysis, special projects, and provides guidance on ICD-10-CM coding, DRG assignments, payments, and auditing processes. Key Responsibilities: Lead and finalize hospital billing and coding audits Identify billing discrepancies and coordinate improper claim payment referrals Analyze and report audit error trends related to documentation and billing practices Compile audit statistics and present findings to internal teams and regulatory agencies Review and improve audit processes and clinical data review initiatives Train and onboard new staff on audit procedures Support compliance with healthcare laws, regulations, and company policies Perform additional special projects as assigned Education & Experience: High School Diploma/GED required Bachelors Degree in Health Information Management preferred or equivalent relevant experience Minimum 3 years of experience in a medical records department within an acute care hospital or healthcare facility Experience with DRG validation, utilization review audits, and ICD-10-CM education required Required Certifications & Licensure: Active RN License required CCS or RHIT/RHIA Certification required Preferred Certifications: CCS CCS-P CCA Preferred Knowledge: Experience with ACCESS Software preferred

About the Company

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Integrated Resources, Inc

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