JOHNS HOPKINS
UNIVERSITY
SCHOOL OF MEDICINE
Clinical Practice
Association
Physicians Billing
Service
JOB DESCRIPTION
Position Title: Coding Specialist II Working Title:
Department: Clinical
Practice Association/ Physicians Billing Service/ [Department]
Reports to: Department Manager
Level: 2 Role: ATO
Salary Range: OF
General
Summary:
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.
Principal
Duties and Responsibilities:
Procedural
Knowledge:
1.
Responsible for all aspects of coding, quality
assurance and compliance with Federal payer
documentation guidelines.
2.
Works closely with Office of Billing Quality
Assurance to include review of documentation.
3.
Serves as departmental expert on coding
questions.
4.
Exercises independent judgment and decision
making on a regular basis with respect to code
selection.
5.
Holds bills and seeks corrective action for
services not meeting documentation requirements in accordance with CPA
policies.
6.
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.
7.
Supports department compliance efforts through
participation in department training and education programs relative to
specific product lines in accordance with established policies.
8.
Conducts feedback/training sessions for
physicians to present the results of medical record documentation as warranted.
9.
Gathers and verifies all information required to
produce a clean claim including special billing procedures that may be defined
by a payer or contract.
10.
Maintains a system of billing accuracy through
encounter verification i.e., clinic schedules, encounter forms, I/P consults,
medical records.
11. Review
and resolve Epic Charge Review edits daily.
12.
May act as a back up to Charge Entry when
needed.
13.
Pro Fee Tracking Database- May fill out missing
information form and forward to the appropriate contact person.
Technical
Knowledge:
•
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
Service
Excellence:
•
Must adhere to Service Excellence Standards.
o Customer
Relations o Self-Management
o Teamwork
o Communications
o Ownership/Accountability
o Continuous
Performance Improvement
REQUIREMENTS
Education
•
High School Diploma or GED.
•
Medical Terminology, Anatomy and Physiology
courses or demonstrated appropriate knowledge.
• CPC
Certification (or department approved certification). Experience
•
Minimum three
years coding experience with demonstrated analytical skills.
•
Experience with Medicare regulations.
PREFERRED
•
Epic experience.
•
Understanding of third party payer issues.
Minimum
Skills & Abilities:
Able to operate basic office
equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc.
Physical
requirements for the job:
Able to sit in a normal seated
position for extended periods of time.
Able to reach by extending
hand(s) or arm(s) in any direction.
Finger dexterity required, able
to manipulate objects with fingers rather than entire hand(s) or arm(s), e.g.,
use of computer keyboard.
Able to communicate using the
spoken and written word.
Able to see within normal
parameters and to hear within normal range.
Able to move about.
Able to
lift minimum weight, 10 lbs.
Rev 4_25_17