Summit Medical Group - Berkeley Heights, NJ

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Respect. Recognition. Rewards.
Discover a whole new experience at Summit Medical Group. With an 80+ year history of unparalleled quality care and patient satisfaction, our team of professionals enjoy a wide range of career opportunities, and an environment where they are respected, recognized and rewarded each and every day.

Coding Compliance Department

Reporting to the Coding Compliance Manager, you will utilize your keen understanding of coding concepts, AMA, CMS/OIG/Federal/State/Local regulations and guidelines, as well as benchmarking standards to ensure compliance and monitor systems for data quality and integrity across various functional applications.

Responsibilities will include:

  • Performing coding/auditing analysis reviews utilizing a risk-based audit approach
  • Providing support for projects in the development of specialty/individual provider educational tools/references
  • Working with teams to resolve coding compliance issues
  • Assisting with research of new services and communication of coding/compliance guidelines
  • Collecting, trending and analyzing data from CMS, RAC and other Payers regarding audit activity, benchmarking standards and other rules/guidelines
  • Preparing written reports of analysis and audit findings
  • Assisting with internal/external audits to monitor compliance
  • Developing/implementing tracking and reporting mechanisms associated with compliance initiatives and activities
  • Applying ethical coding principles/revenue cycle activities to evaluate coding and identify areas of needed review
  • Performing other related functions as assigned

To qualify, you must exhibit strong research skills, including knowledge of automated analysis and online research tools, have an Associate’s Degree (Bachelor’s preferred), along with 5-8 years of related experience including statistical/analysis, coding, auditing and claims reimbursement. Medical Coding Certificate, CPC, CCS-P, CCA or RHIT, and proficiency utilizing VMR/EHR are all required, as is demonstrated proficiency with 1995/1997 auditing tools, ICD-9, CPT, HCPCS coding skills, and an understanding of federal, state and local compliance requirements. Ability to perform analysis reviews and organize, prioritize and manage multiple projects also essential. Excellent analytical, problem-solving, presentation, and oral/written communication skills are a must. Auditing and/or Compliance certification preferred.
We offer a competitive salary, state-of-the-art environment, and a comprehensive benefits package. For immediate consideration, please email and send your resume which must include salary requirements to be considered.


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About this company
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Summit Medical Group is the largest and oldest physician-owned multispecialty practice in New Jersey. In addition to its 250,000-square-foot...