The Quality Officer I is responsible for reviewing inpatient coding accuracy, DRG assignment, and related clinical documentation to ensure integrity, compliance, and appropriate reimbursement. This role supports RWJBarnabas Health facilities by analyzing coded records, providing case-specific feedback to coders, and helping maintain consistent coding quality across the organization.
Key responsibilities include:
- Reviewing ICD-10-CM/PCS coding, CPT coding when applicable, and DRG assignment
- Analyzing inpatient medical records for coding accuracy, SOI, ROM, and POA indicators
- Managing SMART pending queues and EPIC SMART work queues
- Providing clear, clinically supported coding recommendations to coders
- Performing regulatory coding research and documenting review activity
- Supporting coding education, coaching, and workflow improvement across facilities
Requirements & Qualifications
Required qualifications:
- CCS required
- ICD-10-CM/PCS proficiency required
- Bachelor's degree or equivalent experience
- 4+ years of acute care coding and/or auditing experience with a bachelor's degree
- 7+ years of acute coding and/or auditing experience without a bachelor's degree
- Extensive knowledge of ICD-10-CM/PCS and CPT coding
- Strong understanding of medical terminology, anatomy and physiology, clinical indicators, and pharmacology
- Knowledge of billing and coding regulations
- Excellent interpersonal, oral, and written communication skills
- Strong critical thinking, analysis, organization, and time management skills
- Ability to work independently and collaboratively with minimal supervision
- Professional demeanor and the ability to foster positive working relationships
Preferred qualifications:
- CPC-H
- RHIT
- RHIA
- RN
Benefits & Perks
- Paid time off (PTO)
- Medical and prescription drug insurance
- Dental and vision insurance
- Retirement plans
- Short- and long-term disability
- Life and accidental death insurance
- Tuition reimbursement
- Health care and dependent care flexible spending accounts
- Wellness programs
- Voluntary benefits, including pet insurance
- Employee discounts through partner organizations
Location
New Jersey, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$75,597 - $106,780
Remote work allowed
Yes
Posted
2 weeks ago
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