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Job Req ID:  5310

Coding Specialist II

Classified Title:  Coding Specialist II

Role/Level/Range: ATO/2/OF

Starting Hourly Rate Range: $19.24 - $26.46 

Employee Group: Full-Time

Employee Subgroup: (Non-Exempt

Schedule: Monday-Friday, 8:30AM to 5:00PM

Department Name: Radiation Oncology

Personnel Area: School of Medicine

 

General Summary/Purpose

 

Responsible for all aspects of coding, quality assurance and compliance of legal requirements. 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.

 

Specific Duties/Responsibilities

 

Responsible for all aspects of coding, quality assurance and compliance of legal requirements. 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. 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. May review and resolve TES Edits daily.  May obtain correct NPI number and all needed information for Referring Doc Dictionary. 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.  Periodic review with departmental staff of encounter forms or coding forms to ensure they are current.

 

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.
  • Keep current of industry changes by reading assigned material on work related topics.
  • Complete three days of training annually.

 

Department Specific Responsibilities:

 

  • Review Coding updates / changes at Department and Division Faculty meetings.
  • Attend CPA Compliance Meetings when necessary.
  • Review compliance audit results with their providers.
  • Submit TAP user configure changes for their providers.
  • Monitor Provider billing back logs.
  • Submit Fee schedule updates to the IS team
  • Monitor and fix Interface fatal and non-fatal edits.
  • Responsible for New Provider Coding and Tap Training

 

Minimum Qualifications

 

  • High School/GED.
  • Medical Terminology, Anatomy, and Physiology courses or demonstrated appropriate knowledge.
  • CPC Certification (or department approved certification).
  • 3 years related experience in medical billing and demonstrated analytical skills.
  • Recent experience with Medicare regulations
  • Additional education may substitute for required experience, to the extent permitted by the JHU equivalency formula.

 

* JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job. *

 

Preferred Qualifications

 

  • Associates Degree preferred.
  • Epic experience.
  • Understanding of third party payer issues.
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The successful candidate(s) for this position will be subject to a pre-employment background check.

If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the HR Business Services Office at jhurecruitment@jhu.edu. For TTY users, call via Maryland Relay or dial 711.

The following additional provisions may apply, depending on at 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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