RWJBarnabas Health
Job Title
Quality Officer I
Location Remote – candidates must be based in New Jersey, New York or Pennsylvania.
Facility RWJBarnabas Health Corporate Services – 2 Crescent Place, Oceanport, NJ 07757
Department HIM – Coding Quality
Status Full‑Time
Shift Day
Pay Range $75,597.00 – $106,780.00 per year (located in New Jersey). Salary depends on education, experience.
Job Overview The Quality Officer I is responsible for ensuring accuracy and integrity of ICD‑10‑CM/PCS coding and DRG assignment for inpatient encounters for other payers (not Medicare/Managed Medicare). This requires critical thinking and a skill set above what is expected as a coder. Quality Officers must also sustain an excellent organizational average accuracy rate. Adherence to applicable Federal and State Regulations, Compliance Guidelines, and Coding Guidelines set forth by RWJBH, AHA, and AMA must be maintained.
Qualifications – Required
Bachelor's degree or equivalent in experience.
4+ years acute care coding and/or auditing experience with a Bachelor's degree.
7+ years acute coding and/or auditing experience required without a Bachelor's degree.
Extensive knowledge of ICD‑10‑CM/PCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology.
Knowledge of billing and coding regulations.
Excellent interpersonal, oral, and written communication skills.
Excellent organizational and time management skills.
Professional demeanor.
Ability to work independently and cooperatively with minimal supervision.
Foster positive relationships with fellow co‑workers and the coding team.
Qualifications – Preferred
CPC‑H, RHIT, RHIA and/or RN credentials encouraged.
Certifications and Licenses Required
CCS required.
ICD‑10‑CM/PCS proficiency required.
Scheduling Requirements
Monday‑Friday
8:00 am – 4:30 pm
Remote
Full Time
Essential Functions
Ensures accuracy and integrity of ICD‑10‑CM/PCS, CPT coding and DRG assignment in adherence to regulations.
Critically analyzes each inpatient medical record to apply appropriate coding, DRG judgments, SOI, ROM and POA.
Independently manages SMART pending queues for all acute care RWJBarnabas facilities; reviews flagged records.
Independently manages EPIC SMART WQs to assure proper workflow of identified accounts.
Directs coders with case‑specific recommendations; educates and coaches coders on coding principles, sequence, DRG assignment and clinical disease processes.
Sustains an excellent organizational average accuracy rate.
Quality Officer’s coding analysis reviewed by Coding Specialists biannually; consequences of incorrect judgments include increased monitoring until quality scores of 90% or better for two consecutive months.
Ensures correct diagnosis and procedure reporting to prevent impact on patient care and reimbursement flow.
Must meet productivity standards; failure results in progressive disciplinary action.
Monitors SMART queues to ensure records are reviewed and directed appropriately.
Works with other Quality Officers to meet SMART review goals for all facilities.
Reviews discharge status, admission/discharge dates, and other demographics entered by affiliate staff.
Reviews POA indicators for all coded diagnoses.
Reports computer system issues to IT & S or SMART helpdesk.
Maintains records of all review activity.
Communicates coding recommendations and rationale to the coding team.
Performs regulatory coding research as needed.
May perform other related duties.
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
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 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
#J-18808-Ljbffr
Location Remote – candidates must be based in New Jersey, New York or Pennsylvania.
Facility RWJBarnabas Health Corporate Services – 2 Crescent Place, Oceanport, NJ 07757
Department HIM – Coding Quality
Status Full‑Time
Shift Day
Pay Range $75,597.00 – $106,780.00 per year (located in New Jersey). Salary depends on education, experience.
Job Overview The Quality Officer I is responsible for ensuring accuracy and integrity of ICD‑10‑CM/PCS coding and DRG assignment for inpatient encounters for other payers (not Medicare/Managed Medicare). This requires critical thinking and a skill set above what is expected as a coder. Quality Officers must also sustain an excellent organizational average accuracy rate. Adherence to applicable Federal and State Regulations, Compliance Guidelines, and Coding Guidelines set forth by RWJBH, AHA, and AMA must be maintained.
Qualifications – Required
Bachelor's degree or equivalent in experience.
4+ years acute care coding and/or auditing experience with a Bachelor's degree.
7+ years acute coding and/or auditing experience required without a Bachelor's degree.
Extensive knowledge of ICD‑10‑CM/PCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology.
Knowledge of billing and coding regulations.
Excellent interpersonal, oral, and written communication skills.
Excellent organizational and time management skills.
Professional demeanor.
Ability to work independently and cooperatively with minimal supervision.
Foster positive relationships with fellow co‑workers and the coding team.
Qualifications – Preferred
CPC‑H, RHIT, RHIA and/or RN credentials encouraged.
Certifications and Licenses Required
CCS required.
ICD‑10‑CM/PCS proficiency required.
Scheduling Requirements
Monday‑Friday
8:00 am – 4:30 pm
Remote
Full Time
Essential Functions
Ensures accuracy and integrity of ICD‑10‑CM/PCS, CPT coding and DRG assignment in adherence to regulations.
Critically analyzes each inpatient medical record to apply appropriate coding, DRG judgments, SOI, ROM and POA.
Independently manages SMART pending queues for all acute care RWJBarnabas facilities; reviews flagged records.
Independently manages EPIC SMART WQs to assure proper workflow of identified accounts.
Directs coders with case‑specific recommendations; educates and coaches coders on coding principles, sequence, DRG assignment and clinical disease processes.
Sustains an excellent organizational average accuracy rate.
Quality Officer’s coding analysis reviewed by Coding Specialists biannually; consequences of incorrect judgments include increased monitoring until quality scores of 90% or better for two consecutive months.
Ensures correct diagnosis and procedure reporting to prevent impact on patient care and reimbursement flow.
Must meet productivity standards; failure results in progressive disciplinary action.
Monitors SMART queues to ensure records are reviewed and directed appropriately.
Works with other Quality Officers to meet SMART review goals for all facilities.
Reviews discharge status, admission/discharge dates, and other demographics entered by affiliate staff.
Reviews POA indicators for all coded diagnoses.
Reports computer system issues to IT & S or SMART helpdesk.
Maintains records of all review activity.
Communicates coding recommendations and rationale to the coding team.
Performs regulatory coding research as needed.
May perform other related duties.
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
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 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
#J-18808-Ljbffr