Coding Specialist

We are seeking a Coding Specialist who will be 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. Established 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 with 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 ongoing educational activities.
• Assist in the training of staff.
• Keep current on industry changes by reading assigned material on work-related topics.
• Complete three days of training annually.

• 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 ($23.08/hr.  targeted; Commensurate with experience)
Employee group: Full Time 
Schedule: Monday-Friday 8:00-4:30 
Exempt Status: Non-Exempt 
Location: Hybrid/JH at White Marsh 
Department name: SOM Ane Production Unit Billing  
Personnel area: School of Medicine