Classified Title: Coding Specialist II Working Title: Role/Level/Range: ATO 40/E/02/OF Starting Salary Range: $40,820-$56,160 (commensurate with experience) Employee group: Full-Time Schedule: Working 40 hours per week, Monday-Friday 8:30-5pm Exempt Status: Non-Exempt Location: 20-MD:JH at Franklin Square Department name: 10003011-SOM Ortho Production Unit Billing Personnel area: School of Medicine
The Department of Orthopaedic Surgery is seeking a full time Coding Specialist II that will be 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 and Personal Development
Participate in on-going educational activities.
Keep current of industry changes by reading assigned material on work related topics.
Completes three (3) days of training annually.
Minimum Qualifications (Mandatory):
High School Diploma or GED. Three years coding experience with demonstrated analytical skills. Medical Terminology, Anatomy and Physiology courses or demonstrated appropriate knowledge.
Preferred qualifications: Epic experience. Understanding of third party payer issues.
Special knowledge, skills, and abilities:
Experience with Medicare regulations. Able to operate basic office equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc. Must be able to adhere to the Service Excellence Standards: customer relations, self-management, teamwork, communications, ownership & accountability and continuous performance improvement.
Technical qualifications or specialized certifications: CPC Certification (or department approved certification).
Any specific 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.
The successful candidate(s) for this position will be subject to a pre-employment background check.
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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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