HIM Coding Quality Officer , Remote

Job Title:

Quality Officer I

Location:

2 Crescent Place, Oceanport, NJ 07757 (Remote). Candidates must be based in New Jersey, New York, or Pennsylvania.

Department: HIM - Coding Quality

Status:
Full Time, Day shift

Pay Range: $75,597 - $106,780 per year (anticipated for New Jersey).

The Quality Officer I is responsible for ensuring accuracy and integrity of ICD‑10‑CM/PCS coding and DRG assignment for inpatient encounters for non‑Medicare payers. This role requires critical thinking, advanced coding skills, and sustained organizational accuracy rates. Adherence to federal and state regulations, clinical coding guidelines, and institutional standards must be maintained.

• Required:
  
  CCS certification.
• ICD‑10‑CM/PCS proficiency.
• Bachelor’s degree or equivalent experience.
• 4+ years acute care coding and/or auditing experience with a bachelor's, or
• 7+ years acute coding and/or auditing experience without a bachelor's degree.
• Extensive knowledge of ICD‑10‑CM/PCS, CPT coding, medical terminology, human anatomy and physiology, clinical indicators, and pharmacology.
• Knowledge of billing and coding regulations.
• Excellent interpersonal, oral, and written communication skills; critical thinking and analytical writing.
• Excellent organizational and time‑management skills.
• Professional demeanor.
• Ability to work independently and cooperatively with minimal supervision.
• Ability to foster positive relationships with teammates and the coding team.

Preferred
: CPC‑H, RHIT, RHIA and/or RN credentials.

• Monday‑Friday, 40 hours a week, salaried.
• 8:00 AM – 4:30 PM.
• Remote work; residence required in NJ, PA, or NY.

• Ensure the accuracy and integrity of ICD‑10‑CM/PCS and CPT coding, and DRG assignment in accordance with federal and state regulations.
• Critically analyze each inpatient medical record to apply appropriate coding, DRG judgments, SOI, ROM, and POA.
• Independently manage SMART pending queues for all acute care RWJBarnabas facilities; review flagged records.
• Manage EPIC SMART work queues to ensure proper workflow of identified accounts.
• Direct coders with case‑specific recommendations; educate and coach in coding principles, sequencing, DRG assignment, and clinical disease processes.
• Maintain an excellent organizational accuracy rate through advanced coding knowledge.
• Undergo biannual review of coding analysis by Coding Specialists; maintain quality scores of at least 90% for two consecutive months.
• Meet productivity standards; failure may result in disciplinary action.
• Monitor SMART queues to ensure timely review and proper release of records.
• Collaborate with other Quality Officers to meet SMART review goals across RWJBarnabas facilities.
• Review discharge status, admission/discharge dates, and related demographics for accuracy; notify case management as needed.
• Review POA indicators for all diagnoses coded and entered by coders.
• Report system problems to IT & SM or SMART helpdesk.
• Maintain proper computer and written records of all review activity.
• Effectively communicate coding recommendations and rationale to the coding team.
• Perform regulatory coding research as needed.
• May perform other related duties.

This job description is not exhaustive; duties may change at any time with or without notice.

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short‑Term and 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 partners such as NJ Devils, NJ PAC, Verizon, etc.

RWJBarnabas Health is an Equal Opportunity Employer.