Coding Specialist III; Anesthesiology & Critical Care Medicine

Specific Duties & Responsibilities

Procedural Knowledge

• Responsible for all aspects of coding, quality assurance, and compliance with Federal payer documentation guidelines.
• Works closely the 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, and 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 the missing information form and forward it 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

• 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 advanced problem-solving in medical billing and coding.

Professional & Personal Development

• Participate in ongoing 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 providing updates to providers, staff, management, and administration
• Complete three days of training annually.

• High School Diploma or graduation equivalent.
• Five years coding experience with demonstrated analytical skills.

• Medical Terminology, Anatomy and Physiology courses required or demonstrated appropriate knowledge.
• CPC certification.
• Specialty CPC certification or second AAPC certification.
• Experience with Medicare regulations.
• Understanding of third-party payer issues.
• Epic experience preferred.
• Additional education may substitute for required experience, and additional related experience may substitute for required education beyond a high school diploma/graduation equivalent, to the extent permitted by the JHU equivalency formula.

Classified

Title:

Coding Specialist III

Job Posting Title (Working Title):
Coding Specialist III (Anesthesiology & Critical Care Medicine)

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

Starting Salary Range: $24.25 - $42.50 HRLY ($63,000 targeted; Commensurate w/exp.)

Employee group:
Full Time

Schedule:

Monday-Friday (8 hours)

FLSA Status:
Non-Exempt

Location:

Remote

Department name: SOM Ane Production Unit Billing

Personnel area:
School of Medicine