Sr. Coding Specialist

Sr. Coding Specialist

 

Responsible for all aspects of CPT, ICD9, coding, quality assurance and compliance requirements. Work closely with Clinical Practice Association, Office of Billing Quality Assurance, and Production Unit Manager, to include review of documentation. Serve as departmental expert on coding questions, which may arise. Exercise independent judgment and decision making on a regular basis.

Essential Job Functions
Compliance
1. Hold bills and seeks corrective action for services not meeting documentation requirements in accordance with CPA policies.

2. 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.

3. Support department compliance efforts through participation in department training and education programs relative to specific product lines in accordance with established policies.

4. Conduct feedback/ to physicians on trends and or coding suggestions.


Coding
1. Code and post charges based on ICD-9 and CPT stipulations for assigned product lines by dissecting complex payer policy and applying this to the coding process.

2. Gather, verify, and apply the required coding and payer information from ancillary systems (PHs, EPIC, ORCIS, EPR).

3. Maintain expertise in third party/payer specific coding guidelines through an on going review.

4. Capable of advance problem solving on IDX dictionary issues, CPT and ICD-9 codes, ASA codes and time units.

5. Document the coding, policy and procedures for all product lines. 6. Reviews billing vouchers for CPT and compliance requirements.


Quality Assurance and Training
1. Oversees continuous quality improvement in coding.

2. Reviews coded vouchers for QA.

3. Maintains expertise in third party/payer specific coding guidelines through an ongoing review of payer publications; maintains the billing office reference library.

4. Capable of advance problem solving on IDX dictionary issues, CPT and ICD-9 codes, ASA codes and time units.

5. Documents the coding, policy and procedures for all product lines.

6. Works directly with Production Unit Manager

7. Reviews billing vouchers for CPT and compliance requirements.

 

High School diploma or GED required. Two years related experience required. Recent experience with Medicare regulations required. Additional years of related education may be substituted at the rate of one year of experience for 30 semester hours of required education. CPC Certification required. Medical Terminology, Anatomy and Physiology courses required or demonstrated appropriate knowledge required. CPT and ICD-9 coding and coding from medical record documentation or narrative diagnosis or procedures description required. Results oriented with highly effective communication and analytic skills required. Excellent customer service and communications skills required. Thorough understanding of third-party payer issues preferred. IDX billing and Microsoft systems experience preferred. Previous surgical coding experience, orthopaedic surgery preferred.

 

For a full description, view our website at: http://jobs.jhu.edu. Please complete an application and apply online for:  JOB # 33462.We offer a comprehensive salary program and excellent benefits including tuition remission at the University, in a smoke and drug free workplace.  The Johns Hopkins University is an equal opportunity/affirmative action employer committed to recruiting, supporting, and fostering a diverse community of outstanding faculty, staff, and students. All applicants who share this goal are encouraged to apply.  EOE/AA/D/V.