Physician Fee Coding & Audit Specialist 


Company: Capital Health
Job Title: Physician Fee Coding & Audit
Job Type: Full Time
Job Description:
Capital Health is the region's leader in advanced medicine with significant investments in advanced technologies and the best physicians. Comprising its two hospitals (Capital Health Regional Medical Center in Trenton and the Capital Health Medical Center - Hopewell) and the Capital Health - Hamilton outpatient facility, Capital Health is a growing accredited healthcare organization. Capital Health has also received Magnet® status for the fourth consecutive time in recognition of its quality patient care, innovations in professional nursing practice, and nursing excellence. Only 29 organizations in the country have received Magnet status four times and five of those organizations are in New Jersey. In addition, our nursing team received special recognition for excellence in stroke and outpatient emergency care.Responsibilities:•Audits medical record documentation for accurate assignment of diagnosis, current procedural terminology, and evaluation and management codes. Researches coding and reimbursement issues, and reports findings to management, physicians and staff.•Provides ongoing education to physicians and LIPs on documentation requirements for accurate code assignments. Works with supervisor for any training-related questions.•Performs internal quality assessment reviews on physician (professional) coding to ensure compliance with national coding guidelines and Capital Health's policies for complete, accurate and consistent coding that results in appropriate reimbursement and data integrity.•Provides support for coding provider-based billing related claims, including coding professional fees.•Facilitates change processes required to capture needed documentation, such as forms design.•Assists in appeals process resulting from third-party reviews.
Required Qualifications:
•Associate's degree in Health Information Management. RHIT and Certified Professional Coder (CPC) or Certified Coding Specialist–Physician-based (CCS-P) required. Physician coding and training certification.•Three years of related supervisory experience.•CPC or CCS required.•Knowledge of pathophysiology and disease processes.•Strong knowledge of industry guidelines and laws for physician coding and reimbursement. Possesses research and analysis skills.•Proficient with Microsoft applications to include Outlook, Word, Excel, PowerPoint or Access. Medical terminology, anatomy and physiology, or pathophysiology knowledge.•Ability to develop, implement, deliver and assess coding education plans using a variety of methods for individual providers or provider groups.
Preferred Qualifications:
•Physician coding and auditing experience preferred. Professional fee coding a plus.•RHIA or RHIT preferred.
We offer: Competitive salaries•Tuition reimbursement•Low employee expense for medical and dental insurance•403(b) Savings and Retirement ProgramEasy commute from PA and major NJ routes.Find out why our 4,000+ employees have chosen Capital Health.Equal opportunity employer.
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State: NJ

(03/09/21 - 06/07/21)