Coding Specialist III; Anesthesiology & Critical Care Medicine

Coding Specialist III (Anesthesiology & Critical Care Medicine)

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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 the Clinical Practice Association and Office of Billing Quality Assurance to review documentation. It serves as the departmental expert on coding questions, exercises independent judgment, and develops coding and billing change procedures.

The individual will also train staff on all coding and billing changes.

• Responsible for all aspects of coding, quality assurance, and compliance with federal payer documentation guidelines.
• Works closely with the Office of Billing Quality Assurance to review documentation.
• Serves as the 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 from faculty, department, billing staff, and others to ensure compliance with payer regulations and CPA policies and procedures.
• Supports department compliance efforts through participation in training and education programs relative to specific product lines.
• Conducts feedback and training sessions for physicians to present results of medical record documentation as warranted.
• Gathers and verifies all information required to produce a clean claim, including special billing procedures defined by a payer or contract.
• Maintains a system of billing accuracy through encounter verification.
• Reviews and resolves Epic Charge Review Edits daily.
• Acts as backup to Charge Entry when needed.
• Manages Pro Fee Tracking Database by filling out missing information forms and forwarding them.
• Works with Department Management to create Charge Review Rules to prevent unnecessary denials.
• Maintains provider preference lists.
• Provides training on all coding changes to providers and staff, develops presentations, and delivers face‑to‑face training at all Hopkins locations.

• Comprehensive knowledge and compliance with HIPAA rules and regulations regarding patient Protected Health Information.
• Working knowledge of JHU and PBS Billing Applications.
• Utilizes online resources to facilitate efficient claims processing.
• Advanced problem‑solving skills in medical billing and coding.

• Participates in ongoing educational activities.
• Assists in the training of staff, providers, management, and administration.
• Keeps current with industry changes by reading relevant material and providing updates to stakeholders.
• Completes three days of training annually.

• High school diploma or equivalent.
• Five years of coding experience with demonstrated analytical skills.
• Medical terminology, anatomy, and physiology courses required or demonstrated appropriate knowledge.
• CPC certification.
• Specialty CPC certification or second AAPC certification.
• Experience with Medicare regulations.
• Understanding of third‑party payer issues.
• Epic experience preferred.
• Additional education may substitute for required experience, subject to JHU equivalency formula.

Classified

Title:

Coding Specialist III

Job Posting

Title:

Coding Specialist III (Anesthesiology & Critical Care Medicine)

Role/Level/Range: ATO 40/E/03/OG

Starting Salary Range: $24.25 – $42.50 hourly ($63,000 targeted; commensurate with experience)

Employment type: Full Time

Schedule: Monday‑Friday (8 hours)

FLSA Status: Non‑Exempt

Location: Remote

Department: SOM Ane Production Unit Billing

Personnel area: School of Medicine