Classified Title: Coding Specialist III Role/Level/Range: ATO 40/E/02/OG Starting Salary Range: $21.93-$30.18 Employee group: Full Time Schedule: Mon-Fri 40 hrs Exempt Status: Salaried Non-exmt Location: 04-MD:School of Medicine Campus Department name: 10003404-SOM Ane Production Unit Billing Personnel area: School of Medicine
Responsible for providing reports and reconciliation assistance to Sr. Administrative Manager, education to faculty at multiple locations as needed and coding reviews to Clinical Practice Association. Works closely with departmental management and coordinates with the Sr. Administrative Manager and Clinical Practice Association to include review of documentation, coding accuracy and providing timely reporting. Exercises independent judgment and decision making on a regular basis. Responsible for training on all coding and billing changes.
Responsible for understanding coding, quality assurance and compliance regulations with Federal payer documentation guidelines.
Works closely with Sr. Administrative Manager to include review of documentation.
Serves as an expert on coding questions.
Exercises independent judgment and decision making on a regular basis with respect to code selection.
Alerts Production Unit Managers needing 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 be used to review and resolve Epic Charge Review Edits daily.
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.
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 or GED.
Medical Terminology, Anatomy and Physiology courses required or demonstrated appropriate knowledge.
CPC certification – AAPC or AHIMA credentials accepted
Sub specialty coding certification or second AAPC certification in the departmental area of expertise.
Minimum five (5) years coding experience with demonstrated analytical skills.
Experience with Medicare regulations.
Understanding of third party payer issues.
Excellent written and oral communication skills with the ability to communicate effectively with clinic staff, providers, bill staff, management and administration.
Epic EMR experience necessary.
Technical qualifications or specialized certifications:
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.
The successful candidate(s) for this position will be subject to a pre-employment background check.
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