We are seeking a Coding Specialist III who will be responsible for 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. Serves as departmental expert on coding questions. Exercises independent judgment and decision making on a regular basis. Responsible for developing coding and billing change procedures. Responsible for training on all coding and billing changes.

Specific Duties & Responsibilities

Procedural Knowledge

• 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.
• Works with Department Management to create Charge Review Rules to prevent unnecessary denials.
• Works with Department Management on maintenance of provider preference lists.
• Provides training on all coding changes to providers and staff. Develops presentations to effectively communicate how changes will affect provider billing and coding. Provide face to face training on changes to providers based at all Hopkins locations.

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.
• Capable of advance problem solving in medical billing and coding.

Professional & Personal Development

• Participate in on-going educational activities.
• Assist in the training of staff, providers, management and administration.
• Keep current of industry changes by reading assigned material on work related topics and provide updates to providers, staff, management and administration
• Complete three days of training annually.

• High School Diploma/GED. Medical Terminology, Anatomy and Physiology courses required or demonstrated appropriate knowledge.
• CPC certification. Specialty CPC certification or second AAPC certification.
• Five years coding experience with demonstrated analytical skills. Experience with Medicare regulations. Understanding of third-party payer issues. Epic experience preferred.Additional education may substitute for experience to the extent permitted by the JHU equivalency formula.

Classified Title: Coding Specialist III 
Role/Level/Range: ATO 40/E/03/OG  
Starting Salary Range: $24.25 - $42.50 HRLY ($63,000 targeted; Commensurate w/exp.) 
Employee group: Full Time 
Schedule: Monday-Friday (8 hours) 
FLSA Status: Non-Exempt 
Location: Hybrid/JH at Middle River 
Department name: ???????SOM Ane Production Unit Billing  
Personnel area: School of Medicine 

About Johns Hopkins University

Johns Hopkins University remains committed to its founding principle, that education for all students should be grounded in exploration and discovery. Hopkins students are challenged not just to learn but also to advance learning itself. Critical thinking, problem solving, creativity, and entrepreneurship are all encouraged and nourished in this unique educational environment. After more than 130 years, Johns Hopkins remains a world leader in both teaching and research. Faculty members and their research colleagues at the university's Applied Physics Laboratory have each year since 1979 won Johns Hopkins more federal research and development funding than any other university. The university has nine academic divisions and campuses throughout the Baltimore-Washington area. The Krieger School of Arts and Sciences, the Whiting School of Engineering, the School of Education and the Carey Business School are based at the Homewood campus in northern Baltimore. The schools of Medicine, Public Health, and Nursing share a campus in east Baltimore with The Johns Hopkins Hospital. The Peabody Institute, a leading professional school of music, is located on Mount Vernon Place in downtown Bal...timore. The Paul H. Nitze School of Advanced International Studies is located in Washington's Dupont Circle area.

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