Recruitment/Posting Title Billing and Coding Associate Auditor Job Category Staff & Executive - Healthcare Department UFA-Univ Ethics & Compliance Overview Rutgers, The State University of New Jersey, is a leading national research university and the State of New Jersey’s preeminent, comprehensive public institution of higher education. As one of the largest employers in the State of New Jersey, Rutgers University is committed not only to the students and the State that we serve, but also to the faculty and staff who work on our campuses. Ranked in 2022 by Forbes as a top 100 best large employer in America, Rutgers’ commitment to its employees includes maintaining and fostering a safe, diverse, and respectful workplace environment, creating employment opportunities for our nation’s military veterans, and ensuring accessibility and accommodation for individuals with disabilities.University, Ethics and Compliance (UEC) is committed to building an intentionally diverse, equitable and inclusive environment for all employees. We aim to collectively improve our understanding of the variety of personal experiences, values, and worldviews that arise from differences of culture and circumstance. UEC is actively working to identify and eliminate barriers to create a more equitable workplace for all. Our goal is to have an inclusive work environment in which all individuals and groups feel welcomed, respected, supported, and valued. Posting Summary Rutgers, The State University of New Jersey is seeking a Billing and Coding Associate Auditor for the University Ethics and Compliance department. Under the direction of the Director of Enterprise Risk Management and Healthcare Billing and Coding Audit, and the Billing and Coding Manager, this position is responsible for ensuring accuracy and compliance with federal, state and third-party payer rules and regulations governing proper documentation for Rutgers billing and coding practices. The Billing and Coding Associate Auditor provides professional, independent, and objective assessments of the healthcare professionals’ services being audited which includes communicating those assessments by developing comprehensive reporting packages. This role is responsible for reviewing medical records, claims and other necessary documentation to ensure Rutgers healthcare professionals are adhering to coding guidelines and regulatory requirements. The Billing and Coding Associate Auditor conducts required training and education to provide guidance to individual providers and/or departmental/divisional groups based on audit findings, and participates in internal investigations, conducting billing and coding analyses when such expert knowledge is required.

Among the key duties of this position are the following Provides professional expertise in healthcare billing and coding by conducting timely risk-based audits to assist management in accomplishing workplan objectives. Assists in planning audits by identifying potential risk areas, reviewing applicable billing and coding guidelines, and examining departmental/divisional policies, procedures, and agreements. Reviews medical records and related documentation to assess the accuracy and completeness of billing and coding, identifying erroneous billing or discrepancies between billing and documentation. Assesses coding practices against industry standards, governmental regulations, and payer guidelines to ensure compliance. Communicates with the Director, CBM, and Lead Auditor throughout the audit to provide updates on progress, findings, and recommendations. Prepares draft reports of findings, including corrective action recommendations, for review by the Lead Auditor, CBM, or Director, with final approval by the Deputy Chief Compliance Officer or Chief University Compliance Officer before issuing to department/division administrators. Issues final reports upon completion of the exit meeting and receipt of management’s response. Assists in developing and delivering training programs for Rutgers healthcare professionals on billing and coding regulations, ensuring compliance with policies and retraining providers when necessary, with timely post-education audits. Performs other tasks, including developing training materials for the University community in collaboration with UEC Compliance Officers, General Counsel, Labor Relations, and Employment Equity on topics such as federal and state law, University policies, and collective negotiations agreements. Assists in ensuring timely submission of written management responses for final report issuance and evaluating the adequacy of corrective actions. Works with the Lead Auditor to develop options for addressing corrective actions and monitoring their progress to ensure risks are mitigated. Provides expertise to the UEC Investigation unit by conducting billing and coding analyses to assess the validity of allegations and supplying necessary documentation and findings to the assigned investigator. If serving as Lead Investigator, preparing the Investigation Report for review and approval. Keeps leadership informed of status, findings, and observations. Maintains coding certifications and staying current with changes in coding standards, regulations, and Rutgers’ policies through industry associations offering courses, webinars, and articles. Performs other duties as assigned. Position Status Full Time Hours Per Week Daily Work Shift Work Arrangement FLSA Exempt Grade 05 Position Salary Annual Minimum Salary 69031.00 Annual Mid Range Salary 87377.00 Annual Maximum Salary 105722.00 Standard Hours 37.50 Union Description Admin Assembly (MPSC) Payroll Designation PeopleSoft Benefits Rutgers offers a comprehensive benefit program to eligible employees. For details, please go to http://uhr.rutgers.edu/benefits/benefits-overview.



Seniority Unit Terms of Appointment Staff - 12 month Position Pension Eligibility ABP