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Job Details

Coding Compliance Specialist

Requisition #: 188797
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Non-Clinical Professional
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: July 19, 2019

Johns Hopkins Health System employs more than 20,000 people annually. When joining the Johns Hopkins Health System, you became part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. Great careers continually advance here.

Monitors annual code changes implemented by governing bodies. Works with department management and staff as a resourced and to provide guidance on coding issues. Responsible for implementing Johns Hopkins Healthcare’s fee schedules based on plan structure and negotiated contracts with providers. Uses coding expertise to ensure appropriate codes are set up by specialty and/or plan. Uses data sources to determine annual rates for JHHC plans and providers.

Requirements:

A. Education

Requires an AA degree in Business, Health Care Administration or related field, Bachelor’s degree preferred.

B. Knowledge:

Requires strong familiarity with healthcare managed care processes and terminology. Requires a comprehensive and expert understanding of physician billing and coding regulations related to CPT/ICD-9/ICD-10/HCPCS coding. Must be familiar with reimbursement methodologies and guidelines. Knowledge of healthcare regulatory requirements, medical plans and the ability to effectively communicate (oral and written).

C. Skills:

Must be self-motivated and able to work independently to assess situations and respond appropriately; make independent decisions and the ability to accept change. Requires strong analytical and problem solving skills to assess, prioritize and solve complex problems. Excellent interpersonal and oral and written skills to effectively interact with all levels of the company, vendors and consultants. Ability to balance multiple tasks, simultaneously and quickly switch between priorities/tasks. Ability to interact with all levels of staff and adapt to a rapidly changing work environment.

D. Required Licensure, Certification, Etc.:

CPC or AAPC Certification is required.

E. Work Experience:

Professional experience in interpreting medical record documentation and at least 5 years of progressive medical claims or related insurance experience with a minimum of 1 year coding and/or auditing experience.

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

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