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Job Details
Professional Coding Provider Educator and Reviewer
Req #: 0000270619
Category: Education/Training, Healthcare Operations
Status: Full-Time
Shift: Day
Facility: RWJBarnabas Health Corporate Services
Department: HIM - Professional
Pay Range: $86,300.00 - $112,200.00 per year
Location:
2 Crescent Place, Oceanport, NJ 07757
Job Title: Educator
Location: System Business Office
Department Name: HIM - Professional
Req #: 0000270619
Status: Salaried
Shift: Day
Pay Range: $86,300.00 - $112,200.00 per year
Pay Transparency:
The above reflects the anticipated annual salary range for this position if hired to work in New Jersey.
The compensation offered to the candidate selected for the position will depend on several factors, including the candidates educational background, skills and professional experience.
Job Summary:
The Professional Coding Provider Educator and Reviewer prepares educational materials and delivers professional coding and documentation instruction to Medical Group physicians, advanced practice providers, coding staff, and other stakeholders across RWJBH medical centers.
Education may be provided in response to compliance initiatives, physician onboarding, proactive training, coding and regulatory updates, audit findings, physician requests, and leadership direction, and may include large-group presentations and webinar creation and delivery.
This blended education and audit role also performs professional fee coding audits to support accurate, complete, and compliant documentation and code assignment.
The role appropriately researches, understands, interprets, and communicates current CPT, HCPCS, ICD-10-CM, payer, and regulatory guidance and translates complex coding requirements into accurate, concise, provider-facing education and audit feedback.
As a Professional Coding Educator & Reviewer, a typical day might include:
- Prepares, develops, and delivers professional coding and documentation education for physicians, advanced practice providers, coding staff, and other stakeholders, including large-group education and webinar-based education, as directed by management.
- Works directly with our coding vendors and teams for coding operations.
- Creates and delivers onboarding education, annual coding updates, quarterly coding updates, compliance-driven education, specialty-specific education, large-group presentations, and webinar materials when warranted or requested.
- Appropriately researches, understands, interprets, and communicates coding and regulatory guidance when developing education informed by professional fee coding audit findings, compliance initiatives, physician requests, regulatory changes, coding updates, or leadership direction.
- Performs professional fee coding audits to assess support for CPT, HCPCS, ICD-10-CM, modifiers, units, and Evaluation and Management code assignment.
- Documents audit findings in a clear, concise, and evidence-based format, including coding rationale, documentation references, education opportunities, and applicable authoritative guidance when appropriate.
- Provides large-group education, webinar delivery, one-on-one coaching, corrective education, and follow-up education for providers, advanced practice providers, coding staff, or other stakeholders as requested or assigned.
- Incorporates redacted medical record examples to illustrate compliant and non-compliant documentation practices and aligns recommendations with current coding and documentation guidance.
- Identifies documentation gaps, coding risk areas, recurring trends, and potential compliance concerns; escalates complex or high-risk findings through appropriate leadership or compliance channels.
- Responds to coding and documentation inquiries through approved es with authoritative coding references, and logs inquiries to identify trends and future education opportunities.
- Contributes to and maintains a shared repository of professional coding documentation guidelines, payer policies, regulatory references, educational materials, audit tools, and audit-informed education resources.
- Maintains education records, attendance documentation, inquiry logs, audit tracking, follow-up documentation, and summary reports for management review.
- Collaborates with providers, physician leadership, Corporate Compliance, coding leadership, Professional Coding Educators, Auditors, and other stakeholders to support accurate and compliant professional fee coding and documentation practices.
- May perform other duties as assigned or directed by management.
This role might be for you if:
- Advanced knowledge of CPT, HCPCS, ICD-10-CM Official Guidelines, and professional fee documentation requirements.
- Comprehensive understanding of Evaluation and Management coding and documentation guidelines and strong working knowledge of split/shared services, teaching physician rules, incident-to requirements, telehealth regulations, and related professional coding topics.
- Ability to appropriately research, understand, interpret, apply, and communicate official coding and regulatory guidance, including CPT Assistant, CMS manuals, NCDs, LCDs, payer policies, and recognized coding references.
- Proficiency in performing professional fee coding audits, including the ability to audit medical record documentation and prepare clear, evidence-based findings with concise coding rationale and education recommendations.
- Ability to develop and deliver provider-facing education, large-group presentations, and webinars for physicians and advanced practice providers using coding references, redacted medical record examples, and regulatory documentation guidance.
- Delivery may be in person and remote; some travel may be required for on-site education or audits across RWJBH medical centers.
- Strong analytical skills and ability to identify coding risk, documentation gaps, recurring trends, and education opportunities.
- Excellent large-group presentation, webinar facilitation, written, verbal, and interpersonal communication skills.
- Ability to respond professionally to provider and staff coding inquiries.
- Strong organizational and planning skills, including the ability to maintain education schedules and attendance records.
- Advanced Microsoft Office Suite skills, including proficiency in PowerPoint creation and strong to advanced Excel skills; proficiency in Word and Outlook.
- Ability to use electronic health record and coding software platforms, including Epic and coding software such as AAPC Codify, FinThrive, or similar systems.
- Ability to work independently, prioritize multiple assignments, and adapt to changing needs and deadlines.
- The above statements are intended to describe the general nature and level of work being performed.
- They are not intended to be an exhaustive list of all responsibilities, duties and skills required.
To be considered for this opportunity, you must meet the below criteria:
Experience Required:
- Associates degree or equivalent experience required.
- CPC, COC, CEMC, or CPC-I certification required.
- CPMA certification required; credentials must be maintained for continued employment.
- Minimum of five (5) years of professional fee coding experience required, including Evaluation and Management coding, experience creating and delivering coding documentation education to physicians and advanced practice providers, and three to five (3-5) years of experience performing professional fee coding audits.
Experience Preferred:
- Epic electronic health record experience preferred.
- Experience using coding software platforms such as AAPC Codify, FinThrive, or similar coding software preferred.
Why You'll Love Working Here:
At RWJBarnabas Health, our people are at the center of everything we do. Through our Total Wellbeing promise, we offer a wide range of benefits and resources to support your physical, emotional, financial, and professional wellbeing. Highlights include:
- Generous Paid Time Off (Vacation, Holidays, Sick Time)
- Medical, Dental & Vision Insurance
- Prescription Drug Coverage
- Retirement Plans
- Paid Parental Leave
- Tuition Reimbursement
- Student Loan Planning Support
- Life and Disability Insurance
- Wellness Programs and Flexible Spending Accounts
- Voluntary Benefits (like Pet Insurance)
- Discounts with local partners (e.g., NJ Devils, NJPAC, Verizon)
- Community involvement and volunteer opportunities …and more!
Why RWJBarnabas Health:
RWJBarnabas Health is New Jersey's largest and most comprehensive academic health system, committed to delivering exceptional care and creating healthier communities. We're proud to offer a workplace that values compassion, equity, and innovation-where every team member plays a vital role. When you join us, you're not just building a career-you're helping to shape the future of healthcare, one person and one community at a time.
At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.
- 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 is an Equal Opportunity Employer
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