Medical Billing and Coding

• Manage multiple EPIC work queues to ensure timely billing and resolution of all encounters within 2–3 days
• Monitor and audit coder performance, ensuring at least 95% coding and DRG accuracy
• Educate and mentor coding staff, including onboarding, daily coaching, and monthly team meetings
• Liaise with the Coding Division, CDI Program, physicians, and Revenue Integrity to improve documentation, query processes, and charge accuracy
• Conduct daily coding audits and review PSI, Vizient, and 3M data
• Oversee DRG validation and denial management, resolving coding disputes and supporting accurate reimbursement
• Apply national coding standards and metrics, including SOI/ROM, AHRQ PSI criteria, NTAP cases, and Medicare reimbursement systems
• Stay current on Medicare PPS changes, Coding Clinic guidance, SDOH coding, and COVID-related coding
• Drive process improvement initiatives with CDI, Quality, and ER leaders to enhance documentation, reduce denials, and improve national quality ratings
• Perform coding duties as needed to balance workload, reduce discharged-not-billed cases, and meet monthly performance goals

Medical Billing and Coding jobs in New Jersey

Lead Coding Specialist