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Job Details

Coding Specialist (Medicare Risk Adjustment)

Requisition #: 356483
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Coding
Work Shift: Day Shift
Work Week: Full Time
Weekend Work Required: No
Date Posted: Oct. 6, 2021

Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHC is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC has become a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, Johns Hopkins HealthCare is actually doing it. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for the members and communities we serve. If you are interested in improving how healthcare is delivered, join the JHHC team.

Position Summary:

Responsible for all aspects of coding, provider education, practice improvement, quality assurance and compliance with Federal payer documentation guidelines. Serves· as JHHC expert on coding questions. Exercises independent judgment and decision making on a regular basis. Responsible for developing coding and billing change procedures.

Requirements:

Education

Requires High School Diploma or GED. AA degree in Business, Health Care Administration or related field preferred.

Knowledge

Requires familiarity Medical Terminology, Anatomy and Physiology courses required or demonstrated appropriate knowledge. Requires a comprehensive and expert understanding of physician billing and coding regulations related to CPT/ICD-9/ICD-10/HCPCS coding. Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI). Must be familiar with reimbursement methodologies (HCC) and guidelines. Capable of advance problem solving in medical billing and coding.

Skills

Excellent written and oral communication skills with the ability to communicate effectively with clinic staff, providers, bill staff, management and administration. Serves as expert on coding questions

Required Licensure, Certification, Etc.

AAPC and/or AHIMA Certification is required (CPC, CCS, etc.).

Work Experience

Minimum three (3) years coding experience with demonstrated analytical skills. Experience with Medicare (Risk Adjustment) regulations. Understanding of third party payer issues. Preferred EPIC experience.

Machines, Tools, Equipment

Microsoft Suite including Excel and Access. General office and communication equipment

Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.

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