Remote Inpatient Claim Edit Coding Specialist-CCS

The Analyst Inpatient Coding Denials & DNFB (Discharged Not Final Billed), under the coordination of the Lead Analyst Inpatient Coding Denial & DNFB, is responsible for the daily review and management of the Inpatient Coding denials and DNFB for all facilities within the Johns Hopkins Health System. The Analyst Inpatient Coding Denials & DNFB will review and resolve Inpatient claim edits by monitoring aging accounts and prioritizing, providing resolution, and identifying barriers preventing clean claims from being reimbursed timely. The Analyst Inpatient Coding Denials & DNFB will investigate all Inpatient accounts that are not final coded, prioritizing by established criteria such as oldest discharge date, and identify claim issues preventing final coding. The Analyst will work with all key stakeholders to resolve issues impacting coding delays to support DNFB goals.

Registered Remote Locations: Maryland, Virginia, Washington DC, Florida, Pennsylvania, and Delaware

What Awaits You?

• Career growth and development
• Employee and Dependent Tuition Assistance
• Diverse and collaborative working environment
• Affordable and comprehensive benefits package

Education/Experience:

Education/Experience/Certification Track 1: High school diploma w/ CCS required. Experience equivalent to (3) three years of coding inpatient hospital records.
Education/Experience/Certification Track 2: Associates Degree/RHIT required. CCS Preferred. Experience equivalent to (2) two years of coding inpatient hospital records.
Education/Experience/Certification Track 3: Associates Degree/RHIA required. CCS Preferred. Experience equivalent to (1) one year of coding inpatient hospital records.
Required Recruitment Screening: Successful completion of AHIMA approved coding skills assessment: Coding Specialist III

Licensure/Certification:

If qualifying under Track 1, a minimum of an AHIMA credential of CCS is required upon hire.
If qualifying under Track 2 or Track 3, a minimum of an AHIMA credential of RHIT is required upon hire.

Knowledge/Skills:

Knowledge of revenue cycle processes and the relationship of coding to billing. Knowledge of APR-DRG and MS-DRG payer models. Knowledge AHA and CMS rules and regulation for code assignment and denial management. Detailed knowledge of medical coding systems, procedures, documentation requirements and regulatory requirements and Medical Terminology, Clinical Anatomy and Physiological. Knowledge of legal, regulatory, and policy compliance issues related to medical coding diagnoses, procedures and documentation. Knowledge of current and developing issues and trends in medical coding diagnosis and procedures requirements. Ability to resolve complex denials as it relates to coding.

Ability to code using the latest ICD-10CM/PCS coding classification system. Ability to prioritize work and provide prompt efficient service. Ability to analyze and solve problems. Excellent oral and written communication skills. Ability to adapt and modify medical coding processes, protocols, and work within data management systems to meet specific operating requirements.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.