Coding Specialist

5 days ago

Middle River, United States Johns Hopkins University Full time

We are seeking a Coding Specialist 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. Establish 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.
  • May obtain correct NPI number and all needed information from Referring Doc Dictionary. May act as a back up to Charge Entry when needed.
  • 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.


Technical Knowledge

  • 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.


Service Excellence

  • Must adhere to Service Excellence Standards.
    • Customer Relations
    • Self-Management
    • Teamwork
    • Communications
    • Ownership/Accountability
    • Continuous Performance Improvement.


Minimum Qualifications
  • 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.


Preferred Qualifications
  • Epic experience.
  • Understanding of third-party payer issues.

Classified Title: Coding Specialist
Role/Level/Range: ATO 40/E/02/OE
Starting Salary Range: $18.20 - $33.90 HRLY ($54,080 targeted; Commensurate with experience)
Employee group: Full Time
Schedule: M-F; 40hrs/wk
Exempt Status:Non-Exempt
Location:Remote
Department name: SOM DOM Billing
Personnel area: School of Medicine

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