The Coding Specialist is 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.
Principal Duties and 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 for CPT and payer guidelines.
Verify location of codes for appropriateness.
Verify provider type i.e., level 1, 2, etc according to visit and procedure.
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 coding out to fourth or fifth digit as 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 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.
Exercises independent judgment in daily activities.
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.
Must adhere to Service Excellence Standards.
Continuous Performance Improvement
High School Diploma or GED.
Medical Terminology, Anatomy, and Physiology courses or demonstrated appropriate knowledge.
CPC Certification (or department approved certification).
Minimum one year related experience in medical billing and demonstrated analytical skills.
Understanding of third party payer issues.
Minimum Skills & Abilities:
Able to operate basic office equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc.
Physical requirements for the job:
Able to sit in a normal seated position for extended periods of time.
Able to reach by extending hand(s) or arm(s) in any direction.
Finger dexterity required, able to manipulate objects with fingers rather than entire hand(s) or arm(s), e.g., use of computer keyboard.
Able to communicate using the spoken and written word.
Able to see within normal parameters and to hear within normal range.
Able to move about.
Able to lift minimum weight, 10 lbs.
Classified Title:Coding Specialist Role/Level/Range: ATO/02/OE Starting Salary Range:$17.42 - $23.95 (Hourly) Employee Group: Full Time Schedule: Monday - Friday, 8:30 a.m. - 5:00 p.m. (40 Hours/Week) Exempt Status: Non-Exempt Location: White Marsh Department Name: Oncology Personnel Area: School of Medicine
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 email@example.com. For TTY users, call via Maryland Relay or dial 711.
The following additional provisions may apply depending on 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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