Professional Coding Provider Educator & Reviewer

Location: Oceanport

Job Title:

Educator

Location:

System Business Office

Department Name: HIM - Professional

Req #:

Status:
Salaried

Shift: Day

Pay Range: $75,597.00 - $ 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 enterpriseâ€'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 ICDâ€'10â€'CM Official Guidelines and comprehensive understanding of E/M coding, NCCI edits, modifier usage, and payerâ€'specific policies.

* Demonstrated ability to interpret and apply official coding guidance (CPT Assistant, AHA Coding Clinic, CMS manuals); 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 interpersonal communication; strong organizational skills; 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, Encoder Pro, 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 onâ€'site support may be required.

Essential Functions:

* Education

* Prepare, develop, and deliver coding, documentation, and billing education enterpriseâ€'wide, including onboarding, proactive training, complianceâ€'driven topics, and…