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Medical Coding Analyst

2 months ago

Middle River, United States Johns Hopkins University Full time
Position Overview:
We are looking for a dedicated Medical Coding Analyst who will be responsible for the accurate assignment of diagnosis and CPT codes across various departmental billing operations. This role involves reviewing and coding charges for diagnosis and CPT to ensure proper entry into the billing systems.

Key Responsibilities:
  • Procedural Expertise:
    Collect and confirm all necessary information to create a clean claim, including any specific billing procedures dictated by payers or contracts.
  • Ensure appropriate bundling according to CPT code regulations and payer billing standards.
  • Address discrepancies between POS and CPT codes.
  • Identify and verify E/M code types, distinguishing between new and established patients and their corresponding service levels.
  • Maintain a billing accuracy system through thorough encounter verification, including clinic schedules and medical records.
  • Adhere to payer guidelines and limiting coverage protocols for diagnosis coding by utilizing LCD/NCD/payer policy information and applying suitable modifiers as per departmental standards.
  • Assign diagnosis codes with the highest level of specificity applicable.
  • Follow ICD-10 coding standards to ensure appropriateness for each specialty.
  • Conduct daily reviews and resolutions of EPIC Charge Review edits.
  • Research and respond to coding inquiries from physicians, patients, and colleagues as needed.
  • Exercise independent judgment in daily tasks.

Technical Proficiency:
Possess comprehensive knowledge of HIPAA regulations concerning the handling of patient Protected Health Information (PHI). Familiarity with JHU/PBS Billing Applications is essential. Utilize online resources to enhance claims processing efficiency.

Professional Development:
Engage in ongoing educational opportunities and assist in training new staff. Stay updated on industry changes through relevant reading materials and complete required training sessions annually.

Service Excellence:
Commit to Service Excellence Standards, focusing on customer relations, self-management, teamwork, communication, and accountability.

Qualifications:
High School Diploma or GED required. Knowledge of Medical Terminology, Anatomy, and Physiology is essential. CPC Certification or an equivalent department-approved certification is necessary. A minimum of one year of relevant experience in medical billing with demonstrated analytical skills is required. Experience with Epic and understanding of third-party payer issues is preferred. Additional education may substitute for experience as permitted by the JHU equivalency formula.

Work Schedule:
This is a full-time position with a Monday to Friday schedule. The role is non-exempt and allows for remote work.

Compensation:
The salary range is competitive and commensurate with experience, reflecting the institution's commitment to providing a comprehensive rewards package that supports employee health, life, career, and retirement needs.