Coding Specialist

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

Procedural Knowledge

• 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.

• 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.

Classified Title: Coding Specialist

Role/Level/Range: ATO 40/E/02/OE

Starting Salary Range: Min $18.00 - Max $33.50 HRLY ($25.75/hour targeted; Commensurate with experience) Employee group: Full Time

Schedule: M-F

Exempt Status: Non-Exempt

Location: Remote

Department name: SOM DOM Billing

Personnel area: School of Medicine

Equal Opportunity Employer

Johns Hopkins University is an equal opportunity employer and does not discriminate on the basis of race, color, gender, religion, age, sexual orientation, national or ethnic origin, disability, marital status, veteran status, or any other occupationally irrelevant criteria. The university promotes affirmative action for minorities, women, disabled persons, and veterans.