We are seeking a Coding Specialist who will be responsible for diagnosis and CPT coding within the various department billing offices. Will review or code charges for diagnosis and CPT for entry into the JHM and JHU/ PBS billing applications. This can be accomplished through an interface or manual charge entry for services performed at JHM practice sites.
Specific Duties & Responsibilities
Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
Bundle appropriately based on CPT code rule and payer billing guidelines
Resolves POS vs. CPT code discrepancies
Verify E/M code type such as New vs. Established patients and level of service
Responsible for maintaining a system of billing accuracy through encounter verification i.e., clinic schedules, encounter information in EPIC, I/P consults and medical records.
Follows payer guidelines.
Follows limiting coverage guidelines for diagnosis coding by using LCD/NCD/payer policy information and assigns appropriate modifiers based on departmental policy
Carries diagnosis code out to the highest level of specificity that is appropriate
Follows ICD-10 codes to ensure diagnosis codes are appropriate for each specialty.
Review and resolve EPIC Charge Review edits daily.
Will research and respond to coding questions from physicians, patients (via SBO Account WQ) and co-workers as necessary
Exercises independent judgment in daily activities.
Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
Working knowledge of JHU/ PBS Billing Applications.
Utilize online resources to facilitate efficient claims processing.
Professional & Personal Development:
Participate in on-going educational activities.
Assist in the training of staff.
Keep current of industry changes by reading assigned material on work related topics.
Complete three days of training annually.
Must adhere to Service Excellence Standards.
Continuous Performance Improvement.
High School Diploma/GED. Medical Terminology, Anatomy, and Physiology courses or demonstrated appropriate knowledge.
CPC Certification (or department approved certification).
One-year related experience in medical billing and demonstrated analytical skills. Epic experience. Understanding of third-party payer issues.
Additional education may substitute for experience to the extent permitted by the JHU equivalency formula.
Understanding of third-party payer issues.
Classified Title: Coding Specialist Role/Level/Range: ATO 40/E/02/OE Starting Salary Range: Min $18.00 - Max $33.50 HRLY ($23.08/hr. budgeted; Commrensurate with experience) Employee group: Full Time Schedule: Monday-Friday 8:00-4:30 Exempt Status: Non-Exempt Location: Remote Department name: SOM Ane Production Unit Billing Personnel area: School of Medicine
Total Rewards The referenced salary range is based on Johns Hopkins University's good faith belief at the time of posting. Actual compensation may vary based on factors such as geographic location, work experience, market conditions, education/training and skill level. Johns Hopkins offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here: https://hr.jhu.edu/benefits-worklife/
Please refer to the job description above to see which forms of equivalency are permitted for this position. If permitted, equivalencies will follow these guidelines: JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.
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