Coding Specialist II

The Department of Orthopaedic Surgery is seeking a Coding Specialist II who will be responsible for understanding all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines for the Department of Orthopedic Surgery. Works closely with departmental management and coordinates with Clinical Practice Association, Office of Billing Quality Assurance to include review of documentation.

Specific Duties & Responsibilities

Procedural Knowledge

• 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.

Technical Knowledge

• Comprehensive knowledge and compliance of 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 advance problem solving in medical billing and coding.

Professional & Personal Development

• 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.
• Department Specific Responsibilities: None
• Service Excellence (Must adhere to Service Excellence Standards)
• Customer Relations.
• Self-Management.
• Teamwork.
• Communications.
• Ownership/Accountability.
• Continuous Performance Improvement.

• High School Diploma/GED required.
• Medical Terminology, Anatomy and Physiology courses or demonstrated appropriate knowledge.
• CPC Certification(or department approved certification).
• Three years coding experience with demonstrated analytical skills.
• 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: $21.00 - $36.50 HRLY (Commensurate with experience)
Employee group: Full Time
Schedule: Monday - Friday 8:30 Am - 5 PM
Exempt Status:Non-Exempt
Location:Remote
Department name: SOM Ortho Production Unit Billing
Personnel area: School of Medicine