Coding Specialist II; Oncology

Responsibilities

• 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.
• Research and answer 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.
• Reviews patient charges, extracts chargeable items, troubleshoot diagnostic, procedure codes, insurance information, etc. on charge capture encounters before submitting to insurance companies.
• Works closely with Coding Specialist III at Green Spring s Medical Oncology for coverage.
• Pro Fee Tracking Database - May fill out missing information form and forward to the appropriate contact person.

• Serve 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.
• Research and answer 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.
• Reviews patient charges, extracts chargeable items, troubleshoot diagnostic, procedure codes, insurance information, etc. on charge capture encounters before submitting to insurance companies.
• Works closely with Coding Specialist III at Green Spring s Medical Oncology for coverage.
• Pro Fee Tracking Database
  - May fill out missing information form and forward to the appropriate contact person.

• Comprehensive knowledge of, and ensure compliance with, HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
• Working knowledge of JHU/ Epic billing applications.
• Utilize online resources to facilitate efficient claims processing.
• Capable of advanced problem solving in medical billing and coding.

• Participate in on-going educational activities.
• Keep current of industry changes by reading assigned material on work related topics.
• Complete three days of training annually.

• Minimum Qualifications

• High school diploma or graduation equivalent
• Three years of coding experience with demonstrated analytical skills.
• 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.

• Preferred Qualifications

• Medical Terminology, Anatomy and Physiology courses or demonstrated appropriate knowledge.
• CPC Certification (or department approved certification).
• Experience with Medicare regulations.
• Epic experience and understanding of third-party payer issues

Classified

Title:

Coding Specialist II

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

Starting Salary Range: $21.25 - $36.90 HRLY ($27.26/hour targeted; Commensurate w/exp.)

Employee group: Full Time

Schedule: Mon - Fri / 9a - 5:30p

FLSA Status: Non-Exempt

Location: Remote

Department name: SOM Onc Oncology Professional Fees

Personnel area: School of Medicine