Coding Specialist II (Oncology)

We are seeking a Coding Specialist II who will be responsible for all aspects of coding, quality assurance, and compliance with federal payer documentation guidelines. Works closely with department management and coordinates with Clinical Practice Association and Office of Billing Quality Assurance to include review of documentation. Coordinates multi-faceted clinical/research billing to ensure a smoothly functioning billing operation and good patient relations. This includes coordination of the patients' financial billing responsibilities for the Department of Oncology at Green Spring Station. Applies an in-depth knowledge of the EPIC Professional billing systems. Activities, which consist of obtaining and verifying financial and insurance information prior to actual time of service. Requires extensive knowledge of insurance contracts, medical terminology and coding. Assumes administrative tasks, special projects, report of billing and collections, procurements, accounts payable and research patients' financially obligations, and other related activities. This position exercises independent judgment and decision making on a regular basis. This position will also be responsible for supporting office services for processing accounts payable transactions and performing basic monthly reconciliation of accounts. This position will monitor and complete purchases, process routine financial transactions, and enter basic financial data into university systems.

Specific Duties & Responsibilities

Procedural Knowledge

• 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.
• 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., Epic clinic schedules, encounters, medical records.
• 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.
  
  

Technical Knowledge

• 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.
  
  

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.
  
  

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