Coding Specialist III

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 backup 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

Professional & Personal Development

Minimum Qualifications

Preferred Qualifications

Classified Title : Coding Specialist III

Role / Level / Range : ATO 40 / E / 03 / OG

Starting Salary Range : $24.25 - $42.50 HRLY ($30.29 / hour targeted; Commensurate w / exp.)

Employee group : Full Time

Schedule : Monday-Friday (8 hours)

FLSA Status : Non-Exempt

Location : JH at Middle River

Department name : SOM Ane Production Unit Billing

Personnel area : School of Medicine

Total Rewards

The referenced base salary range represents the low and high end of Johns Hopkins University's salary range for this position. Not all candidates will be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate's geographic location, skills, work experience, market conditions, education / training and other qualifications. Johns Hopkins offers a total rewards package that supports our employees' health, life, career and retirement. More information can be found here : https : / / hr.jhu.edu / benefits-worklife / .

Education and Experience Equivalency

Please refer to the job description above to see which forms of equivalency are permitted for this position. If permitted, equivalencies will follow these guidelines : JHU Equivalency Formula : 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. 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.

Applicants Completing Studies

Applicants who do not meet the posted requirements but are completing their final academic semester / quarter will be considered eligible for employment and may be asked to provide additional information confirming their academic completion date.

Background Checks

The successful candidate(s) for this position will be subject to a pre-employment background check. Johns Hopkins is committed to hiring individuals with a justice-involved background, consistent with applicable policies and current practice. A prior criminal history does not automatically preclude candidates from employment at Johns Hopkins University. In accordance with applicable law, the university will review, on an individual basis, the date of a candidate's conviction, the nature of the conviction and how the conviction relates to an essential job-related qualification or function.

Diversity and Inclusion

The Johns Hopkins University values diversity, equity and inclusion and advances these through our key strategic framework, the JHU Roadmap on Diversity and Inclusion .

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

EEO is the Law

https : / / www.eeoc.gov / sites / default / files / 2023-06 / 22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf

Accommodation Information

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 Talent Acquisition Office at jhurecruitment@jhu.edu . For TTY users, call via Maryland Relay or dial 711. For more information about workplace accommodations or accessibility at Johns Hopkins University, please visit https : / / accessibility.jhu.edu / .

Vaccine Requirements

Johns Hopkins University strongly encourages, but no longer requires, at least one dose of the COVID-19 vaccine. The COVID-19 vaccine does not apply to positions located in the State of Florida. We still require all faculty, staff, and students to receive the seasonal flu vaccine . Exceptions to the COVID and flu vaccine requirements may be provided to individuals for religious beliefs or medical reasons. Requests for an exception must be submitted to the JHU vaccination registry. This change does not apply to the School of Medicine (SOM). SOM hires must be fully vaccinated with an FDA COVID-19 vaccination and provide proof of vaccination status. For additional information, applicants for SOM positions should visit https : / / www.hopkinsmedicine.org / coronavirus / covid-19-vaccine / and all other JHU applicants should visit https : / / covidinfo.jhu.edu / health-safety / covid-vaccination-information / .

The following additional provisions may apply, depending upon campus. Your recruiter will advise accordingly.

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.