Coding Specialist III

Inside Higher Ed; Baltimore (MD); On-site; USD 33,406 - 58,548; Full time

Benefits offered by this job

Comprehensive health benefits

401(k) retirement plan

Career development opportunities

Job summary

A healthcare organization is seeking a Coding Specialist III responsible for all coding aspects, quality assurance, and compliance with federal guidelines. The ideal candidate will have a high school diploma or GED, relevant certifications, and at least five years of coding experience, with a strong analytical background. The role includes training staff on coding changes and managing billing accuracy. Competitive salary starting from $24.25 to $42.50 hourly is offered, depending on experience.

Qualifications

• High School Diploma/GED and relevant courses.
• Five years coding experience with demonstrated skills.
• Experience with Medicare regulations.

Responsibilities

• Responsible for coding and compliance with federal guidelines.
• Acts as an expert on coding questions and issues.
• Researches and resolves billing questions for compliance.

Skills

Medical Terminology

Anatomy and Physiology

Analytical Skills

Knowledge of Medicare regulations

Understanding third-party payer issues

Education

High School Diploma/GED

CPC certification

Tools

Epic

Job description

Job Overview

Join to apply for the Coding Specialist III role at Inside Higher Ed.

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. The role works closely with departmental management and coordinates with Clinical Practice Association and Office of Billing Quality Assurance to review documentation. The specialist serves as the departmental expert on coding questions, exercises independent judgment and decision making on a regular basis, and develops coding and billing change procedures and training.

Key Responsibilities

• 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.

Minimum Qualifications

• High School Diploma/GED. Medical Terminology, Anatomy and Physiology courses required or demonstrated appropriate knowledge.
• CPC certification. Specialty CPC certification or second AAPC certification.
• Five years coding experience with demonstrated analytical skills.
• Experience with Medicare regulations.
• Understanding of third-party payer issues.
• Additional education may substitute for required experience and additional related experience may substitute for required education beyond HS Diploma/Graduation Equivalent, to the extent permitted by the JHU equivalency formula.

Preferred Qualifications

• Epic experience preferred

Job Details

• 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

Benefits

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/.

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