Professional Coding Provider Educator & Reviewer

Job Title : Professional Coding Provider Educator &

Reviewer Location : System Business Office Department Name : HIM -

Professional Req : 0000219981 Status : Salaried Shift : Day Pay

Range : $75,597.00 - $106,780.00 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 candidate's educational background, skills

and professional experience. Job Overview : The Professional Coding

Provider Educator / Reviewer is responsible for preparing educational

materials and delivering instruction to Medical Group physicians,

Advance Practice Providers, 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. Education is

delivered in person and remotely as directed. This candidate may

support coding operations, including vendor productivity oversight,

denial analysis, workqueue management, and efficiency of coding

edits and rule sets in Epic. This blended role is accountable for

improving coding quality, reducing denials, and ensuring

enterprise‑wide consistency in coding policy and practice. 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. This job description is not

exhaustive; duties and responsibilities may change with

organizational needs. Qualifications : Required : Associate’s degree

• or equivalent experience required. CPC , or COC required;

credentials must be maintained for continued employment. CPMA

required or willing to obtain within 6 months of onboarding.

Advanced working knowledge of CPT, HCPCS, and ICD‑10‑CM

Official Guidelines and comprehensive understanding of E / M coding,

NCCI edits, modifier usage, and payer‑specific policies.

Demonstrated ability to interpret and apply official coding

familiarity with NCDs / LCDs, CMS guidance, and OIG Work Plan items.

Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)

required. Working knowledge of claim scrub processes, coding edits,

unbilled account monitoring, vendor productivity / quality metrics,

and denial management workflows. Excellent verbal, written, and

attention to detail; ability to prioritize multiple tasks, meet

deadlines, and work independently and collaboratively in a

fast-paced environment. Commitment to maintaining and sharing a

centralized repository of coding references, timely response to

coding inquiries, accurate documentation of interactions, and

ongoing credential maintenance. Preferred : CPB, CEMC, or CPC I

(AAPC approved instructor) strongly preferred. Minimum five years

of professional coding and / or billing experience preferred,

including demonstrated experience in provider education, auditing

or physician coding reviews, E / M coding, and denial management or

revenue cycle exposure. Experience with coding and clinical

platforms (3M, EncoderPro, Epic) preferred. Scheduling

Requirements : Full-Time, Salaried position– 37.5 hours a week The

successful candidate must have the flexibility to report on-site as

needed to support operational or business priorities, including

education delivery and meeting attendance. Ability to deliver

education in person and remotely; some travel for on‑site support

may be required. Essential Functions : Education Prepare, develop,

and deliver coding, documentation, and billing education

enterprise‑wide, including onboarding, proactive training,

compliance‑driven topics, and specialty‑specific updates.

Create annual and quarterly CPT, HCPCS, and ICD‑10‑CM updates

and specialty modules; incorporate redacted record examples with

citations to authoritative guidance. Design and present education

informed by audit findings, compliance reviews, physician requests,

and Steering Committee direction. Deliver one‑on‑one coaching

and small‑group instruction for providers and staff; maintain and

submit attendance records and follow‑up documentation to

management. Audit and Quality Review Perform professional fee

coding and documentation audits across outpatient and inpatient

settings to assess accuracy and compliance of CPT, ICD‑10‑CM,

HCPCS codes, modifiers, and units. Complete assigned provider

reviews per the Physician Review Work Plan, document findings

clearly, and prepare audit summary reports and performance

dashboards. Provide detailed written and verbal feedback tied to

authoritative sources; log and track audit outcomes and corrective

education. Identify documentation and coding risk areas, recurring

trends, and potential compliance issues; escalate complex or

high‑risk findings to the System Professional Coding Quality and

Review Manager or Compliance. Operations and Denials Support

Monitor professional fee work queues, unbilled accounts, and claim

scrub activities to support timely claims submission and adherence

to bill‑hold timelines. Track vendor coder productivity and

quality metrics; escalate operational concerns and coordinate

remediation with vendor partners and leadership. Support the

Denials Team by researching coding‑related denials, documenting

root causes, and implementing targeted and proactive education to

reduce recurrence. Maintain and update coding edits, rule sets, and

workflows in Epic and other coding platforms to improve claim

accuracy and decrease denials. Policy, Research, and Support

Research newly implemented guidance and authoritative resources

(CPT Assistant, AHA Coding Clinic, CMS publications); apply and

share official guidance enterprise‑wide. Develop, document,

implement, and maintain standardized coding policies, procedures,

and a centralized repository of coding references and regulatory

guidance. Respond to coding inquiries via the Coding Support inbox

and other operational channels; provide referenced responses, log

inquiries, and analyze trends to inform education and policy

updates. Collaborate with providers, affiliate staff, internal

coding teams, Compliance, revenue cycle stakeholders, and external

organizations as needed to resolve coding issues and advance

enterprise consistency. Reporting and Continuous Improvement

Prepare and submit regular reports of educational activities,

attendance, audit outcomes, operational metrics, and denial trends

to management. Contribute to internal quality improvement

initiatives and performance dashboards; recommend corrective

actions and measure education and operational impact. Other duties

as assigned. Other Duties : Please note this job description is not

designed to cover or contain a comprehensive listing of activities,

duties or responsibilities that are required of the employee for

this job. Duties, responsibilities and activities may change at any

time with or without notice. Benefits and Perks : 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! Choosing

RWJBarnabas Health! RWJBarnabas Health is the premier health care

destination providing patient-centered, high-quality academic

medicine in a compassionate and equitable manner, while delivering

a best-in-class work experience to every member of the team. We

honor and appreciate the privilege of creating and sustaining

healthier communities, one person and one community at a time. As

the leading academic health system in New Jersey, we advance

innovative strategies in high-quality patient care, education, and

research to address both the clinical and social determinants of

health. RWJBarnabas Health aims to truly make a unique impact in

local communities throughout New Jersey. From vastly improving the

health of local residents to creating educational and career

opportunities, this combination greatly benefits the state. We

understand the growing and evolving needs of residents in New

Jersey—whether that be enhancing the coordination for treating

complex health conditions or improving community health through

local programs and education. Equal Opportunity Employer

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