Description

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