Responsible for understanding all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. Works closely with departmental management and coordinates with Clinical Practice Association, Office of Billing Quality Assurance to include review of documentation
Specific Duties & Responsibilities
- Responsible for all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines.
- Works closely with Office of Billing Quality Assurance to include review of documentation.
- Serves as departmental expert on coding questions.
- Exercises independent judgment and decision making on a regular basis with respect to code selection.
- Holds bills and seeks corrective action for services not meeting documentation requirements in accordance with CPA policies.
- Researches and answers billing and documentation questions or problems submitted by faculty, department, billing staff, and others to ensure compliance with specific payer regulations and CPA policies and procedures.
- Supports department compliance efforts through participation in department training and education programs relative to specific product lines in accordance with established policies.
- Conducts feedback/training sessions for physicians to present the results of medical record documentation as warranted.
- Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
- Maintains a system of billing accuracy through encounter verification i.e., clinic schedules, encounter forms, I/P consults, medical records.
- Review and resolve Epic Charge Review edits daily.
- May act as a back up to Charge Entry when needed.
- Pro Fee Tracking Database- May fill out missing information form and forward to the appropriate contact person.
- Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
- Working knowledge of JHU/ Epic Billing Applications.
- Utilize online resources to facilitate efficient claims processing.
- Capable of advance problem solving in medical billing and coding.
Professional & Personal Development:
- Participate in on-going educational activities.
- Keep current of industry changes by reading assigned material on work related topics.
- Complete three days of training annually.
Department Specific Responsibilities: N/A
- Must adhere to Service Excellence Standards. ?Customer Relations
- Continuous Performance Improvement
Minimum Qualifications (Required)
- CPC Designation
- High School Diploma or GED
- Three (3) years coding experience with demonstrated analytical skills.
- Epic EMR experience
- Understanding of third party payers
- Medical Terminology, Anatomy and Physiology courses or demonstrated appropriate knowledge.
Special Knowledge, Skills, and Abilities
- CPC Certification (or department approved certification).
- Able to operate basic office equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc.
- Experience with Medicare regulations
- Experience with interventional spine/pain management coding helpful.
Classified Title: Coding Specialist II
Working Title: CO Coding Specialist II ?????
Role/Level/Range: ATO 40/E/02/OF
Starting Hourly Pay Rate Range: $19.82 - $27.26/ commensurate with experience
Employee group: Full Time
Schedule: Monday -Friday, 8:30am-5:00pm / 40 hrs per week
Exempt Status: Non-Exempt
Location: 04-MD:School of Medicine Campus
Department name: 10003116-SOM PMR Production Unit Billing
Personnel area: School of Medicine
The successful candidate(s) for this position will be subject to a pre-employment background check.
If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the HR Business Services Office at email@example.com. For TTY users, call via Maryland Relay or dial 711.
The following additional provisions may apply depending on which campus you will work. Your recruiter will advise accordingly.
During the Influenza ('the flu') season, as a condition of employment, The Johns Hopkins Institutions require all employees who provide ongoing services to patients or work in patient care or clinical care areas to have an annual influenza vaccination or possess an approved medical or religious exception. Failure to meet this requirement may result in termination of employment.
The pre-employment physical for positions in clinical areas, laboratories, working with research subjects, or involving community contact requires documentation of immune status against Rubella (German measles), Rubeola (Measles), Mumps, Varicella (chickenpox), Hepatitis B and documentation of having received the Tdap (Tetanus, diphtheria, pertussis) vaccination. This may include documentation of having two (2) MMR vaccines; two (2) Varicella vaccines; or antibody status to these diseases from laboratory testing. Blood tests for immunities to these diseases are ordinarily included in the pre-employment physical exam except for those employees who provide results of blood tests or immunization documentation from their own health care providers. Any vaccinations required for these diseases will be given at no cost in our Occupational Health office.
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